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City Permit N! 5221 - <br />Contractor Address <br />Owner —hn i) CA [-A S QL Address <br />State License No. - <br />Parcel No, <br />City License No, <br />GENERAL PERMIT <br />CUY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 Date G - a Q- -7e <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: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Instil Sewage Disposal Systems: <br />Fee $ Signat of appli t <br />In" Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) Fee S <br />SAC Fee S �� (�. n Signature of 'ty Official <br />State Surtax: Fee S <br />Total Amount Paid to City ......... Fee S -►-� <br />Code: White -File Copy; Canary-laapector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />