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City Permit N o 4973 <br />Contractor,_/C/L Address <br />-- <br />Owner RA, LCn h Address C- e49 l 42A c�%d <br />State License No <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No <br />GENERAL PERMIT <br />CHY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Block Subdivision <br />Date <br />f4-7-7-7 <br />I hereby agree that, in case a permit is granted, all work which shall he done and all materials which shall he 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 />Fee S <br />Sewer Hookup: (City) <br />I cc 5 _ <br />Install Plumbing Systems: <br />Fec S <br />Inst,;. '�isposal Systems: <br />^�' G t> <br />Fee S � <br />Install Water Hookup: Wity) <br />Fee S <br />Install Water Supply Systems: (Hell; <br />Fee $ <br />SAC <br />Fac � <br />State Surtax: <br />Fee $ r.. <br />Signature of applicant <br />Signature of City Offi <br />Total Amount Paid to City . . . . . . . . Fee $ / <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />