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V*J1a" PKmit 1.:' 3 352 <br />Contractor L)%%'y ✓ ! �- Addressr' <br />Owner r_; J Address i, _ H , t/ F- < L-tL <br />State Licensc No. Village License No <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GEN71 RAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivision_ <br />Date /r — I�1 —_7ti <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: Fee $ <br />Install <br />sewage disposal systems: Fee $ <br />Repair <br />Install � <br />Water su Fee $ ��y <br />Repair <br />j Fee $ <br />Total amouni ouid to Village....... <br />Signature of applicant <br />Signature of Village Official <br />