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Village Permit <br />Contractor /& F Address <br />Owner rt � �t,�Z—Ln re: 1 �"1 �E ��— Address. q7 l tLit tn <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />bate l :- ; I 7 ii <br />Parcel No. <br />Section No Lot Block-- Subdivisi <br />Plat No _ <br />Other Description: <br />1 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 thcrrto, and shall include all additional specifications as listed below. <br />Install plumbing systems: Fcc $ Signature of applicant <br />Install <br />scw:rgc dispxnal systems: Fee $ <br />Re'9jt` <br />Install .. !( 0,-. <br />water supply systems: Fee $ <br />Repxrir <br />---- _– -- _ Fee _ <br />Total anunmt pxrid to Village....... $ <br />Signature of Village Official <br />