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City PermitN? 4763 <br />Contractor ) Address <br />Owner � / Address 6- <br />State License No. ` <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License N- <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Block Subdivision <br />Date <br />3-/�Z-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 S <br />Sewer Hookup: (City) <br />[:cc S — <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal systems: <br />Fee S Signature of applicant <br />Install Water Hookup: (City) <br />I ee S <br />Install Water Supply Systems: (Well) <br />Fee S <br />SAC Fee $ r Sit:na rr t (' ty Offic' <br />State Surtax: Fee $ 1 SO <br />Total Amount Paid to City . . . ..... Fee $ /' o.s0 <br />Code: White -File Copy, Canary -Inspector's Copy; Pink -Finance Copy; Gold-AppUcant's Receipt <br />