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City Permit N? 5647 <br />Contractor <br />r+�� j Address <br />Owner 61ka Address_Elm 5 T• <br />State License No. City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Parcel No. <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date A!Z <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 />SAT <br />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Instal Sewsp Disposal Systems <br />Instal Water Hookup: (City) <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Instal Water Supply Systems: (Well) Fee S <br />DO <br />SAC Fee f Z <br />State Surtax: Fee S <br />Total Amount Paid to City ......... Fee S Oo <br />Signature of applicant <br />tc' 1 <br />Code: White -File Copy; Caeary-lespeotor's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />