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City PermitN? 4913 <br />Contractor Address <br />i e <br />Owner Address <br />State License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No. <br />GENERAL PERMIT <br />CP!'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 7 7 <br />Date J <br />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 />/00o <br />f 9c44 � - sl/ <br />Water Meter: <br />Fec $ <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fec $ i ?i.PPl' a <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systt-ms: (Well) <br />Fee $ <br />SAC <br />Fee $ Signature of City Official A <br />State Surtax: <br />O—� <br />Fee S <br />Total Amount Paid to City ......... Fee S g, <br />O - G <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />