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City Permit N? 6452 <br />Contractor l.' I &71 _ � cr-AOLb `r`J-C�� Address a, -7_ A�e-"---_�� <br />Owner - _ Address_— Z O zV '-' 11�� V P <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 />�fl Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 �P. <br />Date — cT-' ` or-/ <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 o!'Orono applicable thereto, and shall include all additional specifications as listed <br />below. <br />Water Meter: <br />Fee $ <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee S _ Signature of applicant •� <br />Install Water Hookup: (City) <br />Fee S - (% <br />Install Water Supply Systems: (Well) Fee $ O 06 <br />SAC Fee S Signature of rity o Ficial <br />State Surtax: Fee S r �n <br />Total Amount Paid to City . .. . .... . Fee $ <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />