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Yiliag# Permit N9 2422 <br />Contractor./W-ix - 'c <br />//. <br />1/Address- <br />Owner ___ <br />cy//^ ■ (/ (V^/e <br />Address.^aJ^-(LO Cjl\.C ^ <br />State License No..Vilhge License No. <br />GENERAL PERMIT <br />^ -I <■ <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date.~f 6 <br />Parcel No, <br />Section No.Lot Block Subdivision. <br />Flat 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 />^ ' .‘L . * . -i <br />Install [Numbing systems: <br />Install <br />Fee $L Signature of applicant <br />sewage disposal systems: Fee V <br />Repair <br />Install <br />Repai|p <br />__i <br />watCT su <br />Pffj <br />FeeltCT supply s)’stems: <br />y:__Fee ^ ^ <br />ignaturc of V'illage Oflyial <br />Total amount paid to Village....... $. <br />i L /h <br />m laiM