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City Permit lv'O 5592 <br />1 , . <br />Contractor �L�� Address <br />Owner Address ✓5- aZ� zz'-. <br />State LicensK . City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />f'rystal Bay, Minnesota <br />473.7357 <br />Date <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 worx 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 />Cite P'f, D r S Tl-r� bic'ZL /,-:f ( C, r5/ <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />FCC $ _ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee $ <br />signature ,f icr fit <br />Install Water Hookup: (City) <br />Fee S— <br />Install Water Supply Systems: (Well) <br />do <br />Fee S 2n <br />SAC <br />Fee S <br />Si • rc of City O' 'cial % <br />j <br />State Surtax: <br />Fee S <br />Total Amount Paid to City ... . .... <br />Fcc S <br />Code: White -File Copy; Canary -Inspector's Copy: Pink -Finance Copy: Gold•Applicant's Receipt <br />