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City Permit N? 6465 <br />Contractor Address /3 3 5z <br />Owner 61 Y' L Address <br />Ci <br />State License No. <br />P,.rcel No. _ <br />—City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date �' 1,:5- — dr- 4 <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 !fisted <br />below. <br />Water Meter. <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />InetaU Sewage Disposal Systems: <br />Install Water Hookup: (City) <br />Install Water Supply Systems: (Weil) <br />SAC <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ ja. n Signar of applicant <br />Fee f <br />Fee S <br />Fee S <br />State Surtax: Fee $ 1 J 6 <br />Total Amount Paid to City ......... Fee S 9,U • Z U <br />Signature of City Official <br />a <br />Code: Wadte-File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />