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Contractor- Ot"Nar-2 Address <br />Owner Address <br />State License No. <br />City Permit ?N O 6027 <br />City License No. <br />GENERAL PERMIT <br />CITY OF OR,ONO <br />Crystal Bay, Minnesota <br />Date 6, —ZS- — Sc-) <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 />shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed <br />below. <br />17 <br />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems <br />Install Water Hookup: (City) <br />Install Water Supply Systems: (Well) <br />IJ <br />Pee $ <br />I -cc S <br />Pee S <br />�7 /p ob <br />I ce $ _�__ <br />Fcc S <br />IeeS <br />SAC I ce S _ Siftnature of City kul <br />State Surtax Fee S <br />total Arnount Paid to City FN i <br />Code White -File Copy, Canary -Inspector's c', i py ; ftliAl sive Copy: GuWApptieant's Rases <br />