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Village Permit 4 9 7 9 <br />Contractor �2'�+�-tea �' is - Address e<: <br />Owner _ --- - Address 1 f / Z.' LI i. , <br />State 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 />Lot— — Block Subdivision <br />Date f / `/— y_T <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 />6:' wit/ -- -. Z 1 23 # / _ <br />Water Meter: Fee S <br />Sewer Hookup: Fee S <br />Install Plumbing Systems: Fee S <br />i Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee $ Ggi7 o <br />Install Water Supply Systems: <br />Fee S <br />Install Sewer Hookup: <br />Fee S <br />S 0 <br />State Surtax: <br />Fee $ • <br />Total Amount Paid to Village........... <br />Fee S <br />,,Signature oof/appli at <br />Signature of Village Official <br />