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City Permit N? _ 5350 <br />Contractor < -=E <br />V67U S U)CLL <br />Address <br />&,-s <br />! A/N <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Owner G4-ADY.S <br />Ot song <br />Address <br />13yd Sae_nue_ <br />PArzK <br />State License No. <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date <br />M.- (,-793 <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 />Water Meter: <br />Fee S <br />Sewer lioakup: (City) <br />Tee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: (City) <br />Tee S <br />Install Water Supply Systems: (Well) <br />Tee $ ZC� <br />SAC <br />Tec S <br />S-0 <br />State Surtax: <br />Tee S <br />�Lj�rpricaot <br />�--�_. <br />Signature of ity Official <br />CD <br />Total Amount Paid to City ......... Fees 2-0 r <br />Code: White -Tile Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />