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Contractor <br />Owner <br />City Permit Nr 00 <br />tA )A_=S7-n,0J jtd PA-- Address <br />Tey <br />Ad dress <br />2y; <br />State License No. City License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 6 ` <br />Date " <br />Block Subdivision <br />6013 <br />r� Z� <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 />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Digx)sal Systerns <br />Install Water Hookup: (City) <br />Install Water Supply systems: (Well) <br />SAC <br />State Surtax <br />'Total Aniount Paid to City . . . . . <br />8(c:13 o.*z3c <br />Fee S7-5� <br />Fee S <br />Hee S <br />I,.CS <br />Fee S ore- <br />_.____._ <br />Fee S <br />F ee $ <br />Nee S <br />F• <br />et <br />Signature o lic <br />Signatureyf ("'it <br />- - <br />ft� ow <br />Code White+fie Copy; ('mazy-Inswrtor's Copy, Pink -Finance Copy. Goid-Applicant's R"vipt <br />