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City Pennit No 5114 <br />ContractorAddress / <br />n 29 LVO <br />Owner R.iCh-11�� �S n-t.•N Address LO-1 - S► j FA'2W/ELe7 <br />State License No. <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No. <br />GE-?ERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 Date 3 2 7 <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 $ <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee S7 <br />Signature 'itsol4 <br />ant <br />rk <br />SAC Fee $ Signature of City Offil <br />State Surtax: Fee S -- <br />Total Amount Paid to City .... ..... Fee S <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />