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City Permit Na 5558 <br />Contractor sL-VtYt Y' d S 0XC Address 43 C0 21 Y r ' v'e <br />Owner 3 "^u Address � `� 3 J �LLI// Eey <br />State License No. <br />Parcel No. <br />City License No, <br />GENERAL PERMIT <br />GTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Section No. Lot I — Block Subdivision I�61'kJ <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 to 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 S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee $ _ <br />S" rat f licant <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />so <br />Fee S '^^ <br />SAC <br />Fee S <br />Signature q, City ffic' <br />State Surtax: <br />Fee S <br />Total Amount Paid to City ......... <br />_ <br />Fee S 20 — <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />