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City Permit IN? 6341 <br />Contractor _ Address 3 ) A <br />Owner Address — <br />State License No. City License No. <br />Parcel No. <br />Section No. _ Lot <br />Plat No. <br />Other Description: <br />GENERAL PER:,iIT <br />GTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 Date & _ /S-tidc-/ <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 S�� <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee $ <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee S <br />Signature of applicant, -7 <br />SAC Fee S Signature of City ficia1 <br />b '7 <br />State Surtax: Fee S i —r6 <br />Total Amount Paid to City . . . . . Fee $ <br />Code: White -File Copy; Canary -Ins -or's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />