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Village Permit <br />Contractor (!, Address <br />n (/i f r 1 2 LI �P.v� /J 2+ <br />Owner Address <br />` yA0&0. /Poa ._.Jetv%rn� o <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date <br />Parcel No <br />Section No Lot... - Block Subdivision <br />Plat 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 />Water Meter: <br />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems <br />Install Water Hookup: <br />Fee S ! y <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Install Water Supply Systems. Fee $ <br />Install Sewer Hookup: Fee S <br />State Surtax: Fee S <br />Total Amount Paid to Village ... ...... Fee S C <br />'1 <br />r <br />Signature of applicant <br />Signature of Village Official <br />