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City PermitN? 5066 <br />Contractor E=f l¢ Address <br />Owner Address <br />State License No. City License No. L� '�— <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <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: <br />Fee S <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee S Si ure applicant <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee $ <br />SAC <br />Fee $ Signature of City Official - <br />State Surtax: <br />Fee $ <br />TOW Amount Paid to City ......... <br />Fee $ <br />Code: Wldte-File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />