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City Permit N? 5917 <br />Contractor - S`Mtr'44 i/y6ZL Address %lyid h%7209 <br />Owner 6�De_gw- _( Ac. MAJ Address to S S END <br />State License No. <br />Parcel No, <br />City License No. <br />GENERAL PERMIT <br />CffY OF ORONO <br />Crystal bay, Minnesota <br />473-7357 Z , Q <br />Date <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 />e_ <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: (City) Fee S <br />ale, <br />Install Water Supply Systems: (Well) Fee S �= <br />SAC Fee $ <br />State Surtax: Fee $ <br />J� <br />Total Amount Paid to City ......... Fee S �0 r <br />F7 <br />Signature of applicant <br />Si atyre of Ci Offic' _ A <br />_"i ZZ, <br />Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />