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City Permit IN? 4760 <br />Contractor_ Address <br />Owner ���a�/ C�z Address 30 5' yi <br />00, <br />State License No. City License No. <br />GENERAL PERMIT <br />GTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Parcel No. <br />Section No. Lot . Block Subdivision <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 be used, <br />shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed <br />below. <br />4- <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee S ��i oo <br />Install Sewage Disposal Systems: <br />Fee $ 4� �� Be Signature o ca ` <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) Fee S <br />SAC Fee $ Signature of City Official <br />State Surtax: Fee $ <br />Total Amount Paid to City ......... Fee $ 6�. 00 <br />Code: White -File Copy; Ca^ary-Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />