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City Permit N? _ 4961 <br />Contractor dress100, <br />f <br />Owner Address__34�-__K�' <br />State License No. City License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />GENERAL PERMIT <br />GTrY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 __ _ _ 7 <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 listed <br />below. <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee $ �D • o <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee $ <br />SAC <br />Fee S <br />State Surtax: <br />Fee $ . _57c, <br />Total Amount Paid to City ......... <br />Fee $ (:) , J1 <br />Sig nsf appli nt <br />�� $ <br />/~_ <br />11 <br />Code: White -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />