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Contractor—:___c <br />Owner <br />&LC <br />State License No. <br />Parcel No. <br />Section No. <br />Plat No <br />Other Description: <br />11 <br />Village License No <br />Village permit N° 4091 <br />,T <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block—_— Subdivision <br />n <br />V a'i- <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 />conmlN with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />--- 3 _ 7 7 / b -------- ----- <br />Water Meter: Fee S _ <br />Se ever Htxrkup: Fee S <br />Install Plumbing Systems: Fee S <br />Install Sewage Disposal Systema Fee S <br />Install Water Hookup. <br />Fee <br />S <br />Install Water Supply Systems <br />Fee <br />S <br />— <br />Install Sewer Harkup <br />Fee <br />S <br />State Surtas <br />Fee <br />S <br />Total Amount Patti lu YdlaEr <br />Fec <br />%� <br />Signature of applicant <br />S*Wttue of Village Official <br />