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Statc License N <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />A <br />Village License No <br />Village Permit N° 4256 <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Bloc Subdivisi <br />Date ,/- % d 7v�_ <br />1 liereby 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 />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Fee S "gc 10 10 <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee S <br />Install Water Supply Systtms: <br />Fee S <br />Install Sewer Hookup: <br />Fee S _ <br />State Surtax: <br />Fee S Ln <br />Total Amount Prid to Village........... <br />Fee S C7 <br />Signature of applicant <br />Signature of Village Official <br />?)�41 A 6A,"" <br />