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Village Permit No <br />( ontractor �,2= Address—/-40 <br />Uwmcr L1l1— f, /�° _ Address- "n n—_ J '1 -- <br />State License <br />Parcel No <br />Section No__ <br />Plat No <br />Other Description: <br />Village License No. — <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lat—_ Block-- Subdivision_ <br />Date.. ����.�— <br />1577 <br />I hereby agree tha., in case a permit is granted, all work which shall be clone 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 />sewage lisposal bystems: <br />Repair <br />Install <br />water sur,,ly systems: <br />e <br />Fee $ — _— <br />Fee $ _ <br />Fee $ 'r _ <br />Fee $—.-- <br />Signaturc of applicant <br />Signature of Village f6ciai <br />t <br />Total amount paid to Village........ $ <br />