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Village Perrr <br />Contractor -AzAZ — ] Address <br />LA <br />� 1 � A J ��, r / /i <br />Owner—_ Address ��L� h- <br />State License No. Village License No <br />Parcel No <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot— BlockC Subdivision <br />Date <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: <br />Install <br />sewage dispesel systesus <br />Repair <br />Install <br />Fee <br />Fee$ %Q•y� <br />Signature of applicant <br />water supply systems: Fee $ <br />Repair r_ Signature of Village Official <br />Fee $ . �h <br />k <br />r o c �A <br />Total amount paid to Village....... $� / Y14 <br />