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City Permit Na 5246 <br />Contracto -A Address <br />Owner �11Address ,3(036 tr <br />47 <br />State License No, <br />Parcel No <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 �t7 <br />Dateo a4 -/ ff *1 <br />Lot Block 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 Meter: Fee f <br />Sewer Hookup: (City) Fee $ <br />Install Plumbing Systems: Fee $ <br />Install Sewage Disposal Systems: Fee S ao• Signature of applicant <br />Install Water Hookup: (City) Fee S <br />Install Water Supply Systems: (Well) Fee $ <br />SAC Fee f �f(cyficial <br />State Surtax: Fee S � s� <br />Total Amount Paid to City .... ..... Fee S n^l,, <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />