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Contractor <br />Owner <br />State License No. <br />Address <br />City Permit N? <br />'A2R_ <br />Address <br />City License No. <br />GENERAL PERMIT <br />QTY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Parcel No. <br />Section No. Lot Block <br />Plat No. <br />Other Description: <br />Subdivision <br />0 <br />Date _.. <br />5718 <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 />AlLAA.71 f- i2_ -1-6, 7 <br />�Jc> i .S <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 />SAC <br />t L <br />Fee S a, <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee S 39 <br />Fee S <br />Fee $ <br />State 'Aurtax: Fee S <br />Total Amount Paid to City . . . . . . . . . Fee S <br />Signat re y Official <br />"'�r '04 Goo 4- tA_t4 <br />Code: White -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />