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Village Permit N° - 4329 <br />Contractor n /� �� A ��` L L Address <br />Owner G't-/ZaY �G'il'ST/1. Address 16 Y <br />State License No. /7'Z 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 Subdivisi <br />Date <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 />Water Meter: <br />Fee c <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 <br />Install Water Supply Systems: <br />Fee S -Q • B0 <br />Install Sew^r Hookup: <br />Fee S <br />State Surtax: <br />Fee S i CI <br />Total Amount Paid to Village........... <br />Fee S -Zell 5 �' <br />Signature of applicant <br />Signature of Village Official <br />i <br />