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City Permit 4972 <br />Contractor <br />Owner ^ C~^^iQ/^r C^c.r ^ T+ Rd. <br />State License No.City License No. <br />GENERAL PERMIT <br />CTIY Cff ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Pate to- 7' 77 <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 />^J3 UJArreB. MemE/t-— ^ ^ ________________________________ <br />Water Meter:Fee $ <br />Sewer Hookup; (City)Fee $ <br />Install Plumbing Systems:Fees <br />Install Sewage Disposal Systems:Fees <br />Install Water Hookup: (City)lI ’cc S <br />InAall Water Supply Systems: (Well)Fee S <br />SAC Fees <br />State Surtax:Fees <br />Total Amount Paid to City................ <br />60.oo <br />/5-oa <br />Signature qf appli^int <br />■ Sn <br />Signature of City Offijjal a <br />/ / <br />Code: WMte-FUe Copy;Canary^Inspector's Copv; Pinkd inance Copy; Guld>ApplicaiU*s Receipt