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Ville Permit N 2 2 4 5 3 <br />Contactor 4� Address <br />` <br />r n � E-t,L - /, • I^ <br />Owner Address /C �y h X <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 Bloch Subdi,4ision <br />Date �- ;h -10 <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, :ball <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />Install plumbing systems: Fee <br />Install <br />sewage disposal systems: Fee <br />`. <br />Repai <br />:. vmt <br />wale supply systems <br />Repair <br />Fee $ / 0 0 O <br />Fee S <br />Total amount paid to Village....... tom_ <br />Signature of applicant <br />Signature of Village Offlcull <br />