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City Permit N? 5826 <br />ContractorW_u D�'►9 = 1;1CO5' Address --zrg/IAZ_q!L <br />Owner_ y Z4,r==[0 N Address ZIB (f <br />State License No, <br />Parcel No, <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No, <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 <br />Date <br />Lot Block Subdivision <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 />Fee $ <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee $ 200— <br />Sig�re 4 app o nt <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee $ _ <br />SAC <br />Fee $ <br />Si nature , <br />ST <br />otrffic' <br />State Surtax: <br />Fee $ <br />/ <br />"-- <br />Total Amount Paid to City ......... <br />Fee S <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />