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City hrmit IN 0 5998 <br />Contractor 6�/911,P..:r /�IV- Address n <br />Owner jya.,m r k- Address #6r l <br />State License No. — City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Parcel No. <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 be done and all materials which shall be used, <br />shaft comply with the City Code of Orono applicable thereto, and shall include al' additional specifications as listed <br />below. <br />Water Meter. <br />Fee S <br />Seiner 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 S <br />Install water Supply Systems: (WA) <br />Fee S 0o <br />SAC <br />Fee S <br />State Surtax: <br />Fee S .50 <br />Total Amount Paid to City .... .... <br />. Fee S �,1� , 5 D <br />��1)tnrrmlr 'cant <br />L <br />Signature of City Official <br />=�_NZ <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />