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City Permit 1`j 9 4966 <br />Contractor �Address <br />Owner �k:GICs^✓ Address <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 />CITY OF ORONO <br />Crystal Day, Minnesota <br />473-7357 <br />Date <br />Block Subdivision <br />1194-77 <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 />Sign:,ture �If applicant <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee S <br />SAC <br />Fee $ <br />Si re of City Offic <br />State Surtax: <br />Fee S <br />Total Amount Paid to City ......... Fee S 120. SO <br />Code: White-Flle Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />