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City Permit N? 6258 <br />Contractor J`G 0CA WF—LL Co <br />Address <br />MT" <br />1AVA <br />Owner RF_1] F i E L[Y kam �_:7 <br />Address —P;?3'7 <br />S <br />Q& v I ve, /, q <br />State License Nr <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />GTl'Y OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 n2 _ �o ` p I <br />Date OO <br />Section No. Lot Block <br />Plat No. <br />Other Description: <br />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 Motor: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Storage Disposal Systems: <br />Fee S <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Weil) Fee S ,�?Q • 4111110 <br />Signature of applicant <br />i <br />SAC Fee S Signature of ity Officia <br />State Surtax: Fee $ 1 5-0 — <br />Total Amount Paid to City ......... Fee S - so <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />