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City Perry I N? . 4618 <br />Contractor Address IIu� <br />Owner6.)Address <br />State License No. City License No. _ <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay. Minnesota D <br />473.7357 Date J 22" 7` <br />Parcel No. <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />1 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 />✓1 <br />Water Meter: <br />Fee S <br />Seam Hs�hJv (City) <br />Fee S <br />Inman Plumbing Systems: <br />7� <br />Fee S <br />InttallSewage Disposal Syst. <br />Fee S <br />Install Water Hookup: (r!' <br />)-et S <br />Iowan Water Supply syste <br />Fee S <br />oo <br />SlRnatu�Fto ppUan <br />SAC Fee S Signature of City official <br />State Surtax: Fee S <br />Total AmouriI PaW to City ......... Feu • <br />Code: Wrdt@�Fllr Copy;Cawary-lasiam at's Copy; link-Flnanat Copy: Cold-Applicam s Raearlpt <br />