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Village Permit <br />Contractor ,�'^ � � �1Lk4,4 dOL Address <br />Owner 4`1 c! U � 1 (Jt �c C Address �3 ��i 1 / 4- <br />State License No. _ Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No. -- <br />Section No Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date /- - ,,� 4 7 Z <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />Install plumbing systems: Fcc $ <br />Install <br />sewage disposal systems: Fee $ — <br />Repair <br />Install ,c A �, <br />water sr4pply-•�' Fee $ziio <br />Repair <br />Fee $ <br />Total amount paid to Village....... $ <br />Signature of applicant <br />Signature of Village Official <br />