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Village Permit N? 4 2 7 9* <br />Contractor �"Y1 C�/ Address <br />Owner !1bitult- i, A Address �-�� i1-� yu�t ► d` <br />State License No <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 />Date <br />L ,t_ 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 bet w. <br />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Disposal Systems: <br />Fee S - <br />Signature of applicant <br />Install Sewage <br />Install Water Hookup: <br />Fee S <br />Install Water Supply Systems: <br />Fee S <br />Install Sewer Hookup: <br />Fee 5 <br />.� <br />Signature of Village Official <br />State Surtax: <br />Fee S '5 /0 <br />_ <br />C '51) <br />Total Amount Paid to Village........... <br />Fee S <br />