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Village Permit N° .. 4111 <br />Contractor Address <br />Owner. Address— � <br />State License No. Village License N <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No <br />Section No Lot Block Sur .':vision <br />Plat No <br />Other Description: <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 />Sewer Hookup: <br />Install Plumbing Sys ms: <br />Install Sewage Dit, <br />s <br />Install Water Hookup. <br />Install Water Supply SyNtems: <br />Fee S <br />Fee S <br />Fee S _ <br />Fee S O D <br />Fee S <br />Fee S <br />[•%fall Sewer Hookup Fee S /+ <br />State Surtax: Fee S l C% <br />Total Amount Paid to Village........... Fee S 4 <br />Signature of applicant <br />Signature of Village Official <br />