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\ <br />Villag* Ptrmit ..M m 3551 <br />itacMTy^Ci'^^. iLu^r^^Address <br />Owner.C^2^3_J_Address. <br />-----------^«9 S t <br />rrf-.,/C/-r~~^^*^ <br />/ <br />State License No..Vilbge License No. <br />% <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota . I <br />Date.i - j cJ / yj* <br />Section No. <br />Parcel No. <br />Plat No— <br />BV Subdivision. <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 J <br />comply with the Vilbge Code of Orono applicable thereto^ and shall include all additional specifications os listed bdow. <br />i «/j <br />Water Meter:Fees <br />Sewer Hookup:Fees <br />Install Plumbing Systems:Fee S <br />Install Sewage Disposal Systems:Fee S /o-lV <br />Install Water Hookup:Fee S <br />Install Water Supply Systems:Fees. <br />Install Sewer Hookup:Fees <br />State Surtax:Fees . T J <br />Total Amount Paid to Village ....................Fees./cf, <br />Signature of applicant <br />0 ' 1 <br />Signature of Vilbge Official <br />y <br />. dy, ----^