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City Permit N0 4899 <br />Contractor_ 12y :ems Address <br />Owner /� �-�i� � Address e�� z(° - - <br />State License No. <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date '.�" ..7 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 $ <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />` <br />Fee $ll� <br />SAC <br />Fee $ <br />Signature of <br />Signature of City Official <br />State Surtax: Fee $ S <br />Total Amount Paid to City ... ... Fee $ a <br />s <br />Code: White -File Copy: Canary -Inspector's Copy: Pink -Finance Copy; Gold -Applicant's Receipt <br />