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Village Permit N° 4122 <br />lrx,- <br />Contractor 'I J ` -S Address 47-�5� ��f r <br />Owner. �V �/ m r _Address �y'0e " � <br />State License No. .27-0/c/ Village License No. /�, E %�/" <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivision_ <br />Date / 1 7 /7 - <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: Fee S <br />Sewer Hookup: Fee S <br />Install Plumbing Systems: Fee S <br />Install Sewage Disposal Systems: F::e 5 <br />Install Water hookup: Fee S <br />Install Water Supply Systems: Fee S <br />Install Sewer hookup: Fee S <br />State Surtax: Fee S <br />Total Amount Paid to Village........... Fee S -� <br />Signature of applicant <br />Signature of. Village Official <br />