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CityPermitN° 5293 <br />Contractor SkL,4-Z11A v-Q9FVleic5: Address _ OVA 51-Z' A" <br />Owner 9E-� J c19c C� FA1 Address 3067 64fz-y/E lV <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 />GTrY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <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 !;sted <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 S Z� <br />Install Water Hookup: (City) <br />Fee S _ <br />Install Water Supply Systems: (Well) Fee S <br />re of appB � •- <br />I <br />SAC Fee $ Signature `City O[ I <br />1� <br />State Surtax: Fee S <br />�b <br />Total Amount Paid to City ... . . .... Fee S 20 —Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />