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City Permit N? 5781 <br />Contractor ^ 1 T VS. ^ nT________ <br />Owner l^C / CQA 1\J SO (J <br />Address <br />, Address.12-.“! t fZJ^or <br />State License No.,.City License No.. <br />GENERAL PERMIT <br />cm OF ORONO <br />Parcel No--------- <br />Section No____________Lot. <br />Plat No_______ <br />Other Description: <br />Crystal Bay, Minnesota <br />473-7357 <br />Date./^-;2</- 7? <br />. 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, <br />shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed <br />below. <br />iWecAv — lA A lo o Cn cAr.' Ft g. ep /. ______o?iO. ________________ <br />R-uH-rr-Z/O R>* CbtA>v\ . <br />Water Meter: Fee $ . <br />Sewer Hookup: (City) Fee $ , <br />Install Plumbing Systems: Fee S . <br />Install Sewage Disposal Systems: Fee S <br />Install Water Hookup: (City) Fee S <br />SAC <br />State Surtax: <br />Total Amount Paid to City <br />Install Water Supply Systems; OVell) Fee S <br />Fees __Signature o! <br />Fee S X <br />...........Fee S CLC / <br />Code: White-File Copy; Canary-Inspector’s Copy; Pink-Finance Copy; Gold-Applicant’s Receipt <br />itufcq^ity Official / //