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City Permit N? 5829 <br />Contractor L&)e.,, . A., 1: Address ,?�US' rY/1.� A <br />Owner k. , , " -) Address X96 .�� a1L ��• "� t� <br />State License No. <br />Parcel No. <br />City License No. _ __ _ <br />GENERAL PERMIT <br />CnT OF ORONO <br />Crystal Bay, Nlinncsoi.i <br />473.7357 I).tt�•1i :����� <br />Section No. Lot _ Block Subdivision <br />Plat No. <br />Other Description: <br />I hereby agree that, in case a permit is granted, all wo.'• 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 />Water Meter: <br />Serer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: Wity) <br />Install Water Supply Systems: (Well) <br />SAC <br />Fee S <br />Fee S <br />Fee $ <br />Fee $D. <br />SiR turc of applicant �y <br />�� /`? v....✓t <br />Fee $ <br />Fee $ <br />1•ce S <br />State Surtax: Fee S a .�_V <br />Total Amount Paid to City ......... Fee S W • s� <br />Signature of City Official <br />Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />