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City Permit No 5462 <br />Contractor ® SypIoLA W ELk Address /3-36 N-w Y :2 <br />Owner G%-_V R-r-k= .� ACKSo^L Addres3 22—%CD Dtcy/Al <br />State License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No. <br />_' ENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 /_ /Z _ %q <br />Date / <br />Block Subdivision <br />6 <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 />6etPr of _cT Y __ WLPLL QEG02'D To C/ TY <br />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: (City) <br />Instal' Water Supply Systems: (Well) <br />SAC <br />State Surtax: <br />Fee $ <br />Fee S <br />Fee $ <br />Fee $ Signature of applicant <br />Fee $ <br />Fee S <br />Fee S Signature of Cit ffic' 1 <br />Fee S <br />Total Amount Paid to City ... ...... Fee S _ <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />