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Village Permit No 643 <br />Contractor 1,1 114-9 , q/�l <br />AddiCssi� <br />.--KL _�� - -- <br />Owner!' l' r Address <br />G <br />State License No.— Vike License No. <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />p Date � <br />Parcel No._K �/- �' <br />Section No-1—__ Lotl____ Bloch—_.__ SubdivisionT��'-�%!r� Est, <br />Plat No — <br />Other Description: <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 />Install plumbing systems <br />Install <br />Repair sewage disposal systenis <br />Install <br />uwater supply systems: <br />M <br />FCC $__ _ Signature of applicant <br />FCC <br />ov <br />Fee $_i._Q. _ <br />�- <br />Fee $_- Signature of Village Official <br />o r" <br />Total a►. ount paid to Village....... $_ <br />