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Contractor Address &(r <br />21 <br />t* <br />OWI1Cr_ S� �K._ ,,A -- - -- Address r <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 />Village Permit Ng 2043 <br />DateL- 'L� - <br />Lot_ _ Block—_ . Subdivision-- <br />I <br />ubdivision __-_ <br />I hereby agree that, in case a permit is granted, all <br />work which <br />shall <br />be done <br />and all materials which shall <br />be used, shall <br />comply with the Village <br />Code of Orono applicable <br />thereto, and <br />shall <br />include <br />all additional specifications as <br />listed below. <br />Install plumbing systems: <br />lilt"Wil scm•age disp,sal systems: <br />R <br />water supply systems: <br />Repair <br />Fcc $--- -- --- <br />Fee $ - - - <br />Fee , D <br />Fee �__ i - T / <br />n <br />Total amount paid to \ illage.... S -t. C 0 <br />Signature of applicant <br />siguato►c 14 \ illagc Ofire]*l <br />'�' f L_-- <br />