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<br /> City permitN? 5286
<br /> Contractor It/Iare.ie,t,f.".e... O`!..r.imilti Address ivt.,.c+K.
<br /> Owner /6.4.....kt-c.re, >iGi'Tt-,at"ri..J Address P7,4-0 alh ZfiC d*,�-c r✓
<br /> State License No. City License No.
<br /> GENERAL PERMIT 1
<br /> CITY OF ORONO 1
<br /> Crystal Bay, Minnesota 7/
<br /> r 473.7357 / 7
<br /> Date 1-
<br /> 1
<br /> Parcel No._ 1
<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 he done and all materials which shall be used.
<br /> shall comply with the City Code of Orono applicable thereto,and shall include all additional specifications as listed
<br /> below.
<br /> p:.
<br /> Witer Meter: Fee S tt,
<br /> Sewer Hookup:(City) t're S '
<br /> Install Numbing Systems: Fee S
<br /> Instate Synge Disposal Symms: I°ee S v[`• Slgh a eNihon 24,/ � ll' e`2" 3
<br /> Nein want Hookup:(City) Lire S !/ �
<br /> Install Water Supply Systems:(Well) Fee S
<br /> SAC Fee S Siena! of �pff chef
<br /> Sha Surtax. Fee S
<br /> Xi
<br /> total Amount hid to Clty Fee S ,Ile'se,
<br /> Code:WMt .FMe Copy;Canerylnspector's Copy:Mnk•Fimnce Copy;Gold•Applicant's Receipt
<br /> ....... .. .. ... ......0.e e, - `�, t 4
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