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City PSimit N9 4623 i <br />Contractor. <br />Owner___ <br />s.Address <br />Address. <br />State License No. City License No. <br />GENERAL PERMIT <br />CITY OP ORONO *• <br />Crystal Bay, Minnesota <br />473.7357 <br />Date 9-S7-7^ <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 />Water Meter:Feel ^ ^0 <br />Sewer Hookup: (City)Fees ^ 0 <br />InttaU Plumbing Sy items:Fee S <br />Install Diqwttl Syitemi:Fee S <br />Install gfister Hookup: (City)Fees <br />Install Water Supply Systems: (Weil)Fees <br />SAC Fees <br />State Surtax:Fee 1 // <br />Total Amount Paid to Gty................ . Fee S OQ j <br />Signature of applicant <br />Code: White-File Copy;Canary-Inipcctor’i Copy ; Pink-Finance Copy; Gold-Applicant'i Receipt