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v116ge pw.* N° 4213 <br />Contactor °� P- Add t <br />Owner r,Cl� c �' Address <br />Statc License No. Village License No <br />Parcel No <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lo+ BlodSubdivis' <br />D,t,i2 19-;7y <br />I hereby agnx that, in case a permit is granted, all work which shall be done and all materiah which shall be used, sW <br />comply with the Village Code of Orono applicable theretq and shall include all additional specifications as listed blow. <br />23 Flo 77 �. <br />51 F737 <br />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Fee S <br />Install rlumbft Systems: <br />Fee S. <br />Install Sewage Disposal Systems: <br />Fee S <br />Signature of applicant <br />Install Water Hookup: <br />-� <br />Fee S O <br />Install Water Supply Systems: <br />Fee S <br />Install Sewer Hookup: <br />Fee S <br />Signature of Village Oicial <br />State Surtax: <br />Total Amount Paid to Villase........... <br />Fee S X 1 <br />q Y <br />Fee S / 2� <br />��� ��"' _ L2° <br />