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City Permit N? 5030 <br />Contractor Wf S ' �' " Address <br />Owner L t A ss ,I-� 7 6 <br />State License No, <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No, <br />GENERAL PERMIT <br />GTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Lot Block Subdivision <br />//-3ci —%7 <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 />%8 /nc Tt k vZ 54IV X9.3 / <br />-Re #Ra 8 S 8 <br />1X60 <br />Fee <br />Water Meter: <br />S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage I.isposal Systems: <br />Fee $ <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee S <br />SAC <br />Fee $ <br />State Surtax: <br />Fee S � <br />Total Amount Paid to City . .. . . .. <br />. . Fee S y C <br />�� J <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />