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Village Permit N° 4 4 8 6 <br />r�'I� �l 6tnb << <br />Contractor Address_ <br />� D <br />Owner Lit n'1 C �� f' Address 1711 F E ekness <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date / — 7— 7 6 <br />Parcel No. <br />Section No Lot Block Subdivision <br />Plat No <br />Other Desr•ription: <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 />2�1� & <br />75- <br />fY/ # c? % <br />Water Meter: <br />Fee S 4/1-11,11 <br />Sewer Hookup: <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee S h c� <br />Install Water Supply Systems: <br />Fee S _ <br />Install Sewer Hookup: <br />Fee S <br />_lam% <br />State Surtax: <br />Fee S <br />Total Amount Paid to Village........... <br />Fee S 5 <br />Signature of applicant <br />Signature of Village Official <br />