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Village Permit N° _ 4123 <br />��/ . <br />Contractor Add - <br />Owner h'``" C"_' `"`.0 Address <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 />note 1' 4 r 7r <br />I hereby agree that, in cese 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 />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: <br />Install Water Supply Systems: <br />Install Sewer Hookup: <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee � <br />Fee S <br />State Surtax: Fee S SD <br />Total Amount Paid to Village........... Fee S k • S--y <br />Signature of applicant <br />Signature of Village Official <br />�=/a_ � <br />