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Contra -for <br />Owner-- - <br />se N <br />Section No <br />004r Description; <br />Village Permit <br />_- 7 JAddres <br />Ad <br />it ')Ucense No <br />GE lvj L P M <br />VI A�E, OF ORO,I� <br />Crystal it Miffnesota <br />1 <br />Date <br />Parcel <br />!, Lot $lode Subdivision <br />Plat No <br />I hereby agree that, irk case a per <br />comply with the Village C gde'of, <br />r <br />t <br />n# is granted, all work which skAIr be- dome and all materials which shall be used, shall <br />ionb ^apod2ble thereto, aJ shall include —all additional specifications as listed below. <br />rL eJ1. — Op / �T� c� J <br />CA- . o <br />11 <br />Install plumbing systems: Fee $ Signature of applicant <br />i <br />Install -� <br />sewage disposal systems: Fee $ ;r <br />Repair <br />Install <br />water supply systems: Fee $ZG <br />Repair �� Signature of Village Official '* <br />Fee $ <br />Total amount paid to Villag��G.1$�� ' <br />