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City Permit IN? 5433 <br />Contractor A&ADIG W C -DN Address yZ / KEEoX <br />Owner re /,CXV ^j Address y0/0 $AL"i/D� <br />State License No. <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />GTl'Y OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 Date // _3 D — 70 <br />Section No. Lot Block Subdivision <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, <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 />Fee S <br />Sewer Hookup: (City) <br />Fee $ _ <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) Fee $ <br />Stfirt r of applica t <br />c> <br />SAC Fee S Signature of City Official <br />State Surtax: Fee S - <br />Total Amount Paid to City ... ...... Fee S `o _L _i:-> <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />