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Village Permit N° 3902 <br />Contractor ' __. i ,� Address <br />Owner �2 z, { . �4 Address <br />State Licensc No. Village License No <br />Parcel No. <br />Section No <br />Plat No. <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date— <br />"ot _ Block Subdivision <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 />Fee S <br />Sewer Hookup: <br />Fee S <br />Install Plumbing Systems: <br />Fee 5 <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee S <br />Install Water Supply Systems: <br />Fee S ZL) <br />Install Sewer Hookup <br />Fee S <br />State Surtax: <br />Fee S <br />Total Amount Paid to Village.. ........ Fee S <br />Signature of applicant <br />Signature of Village Official <br />61 L <br />