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City Permit N? 5646 <br />Contractor Out wvze� go -ear Address �i�NCr <br />&X. <br />Owner AERRS/ 44LhRt0_+4- Address 0390 Fox ST. <br />State License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City ? icense No. <br />GENERAL PERMIT <br />CTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 <br />Date <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 />♦ ,SZ � � <br />Water Meter: <br />Fee $ _ <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />ep <br />Fee S Signature of a icant <br />Install Water Hookup: (City) <br />Fee S —% <br />Install Water Supply Systems: ;Well) <br />l cc $ <br />SAC Fee $ i Signatuw of city <br />Official <br />State Surtax: Fee S <br />Total Amount Paid to City . .. . . ... . Fee $ <br />Code: white -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />