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Village Permit N! 1614 <br />Contractor t�ten r' Address <br />Owner— w _, 11_Q l?1.� Address 16 7� G / ✓1 <br />State Liccnsc <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />Village Liccnsc No. — <br />GENERAL PERMIT <br />V '.NLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivision <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 Villagc Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />Install plumbing systems: <br />Fee $ <br />Install <br />sewage disposal systems: <br />Fee $ <br />9r <br />Ins <br />Fee $ �'C <br />R it water supply systems: <br />epa <br />-- <br />Fee $ <br />Signature of a�)plicant <br />Signature of Village cial <br />Total amount paid to Village........ $— - - <br />