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City Permit?�a _ 4362 <br /> / l r <br /> Contractor i�� • :��dress � <br /> Owner , 1� Address �_ <br /> State License No. City License No. <br /> GENERAL PERNIIT <br /> � C�IrI'Y OF �RON4 <br /> Crystal Bay, biinnesota <br /> 473•7357 A, 3 _ ? <br /> Date � � <br /> Parcel Na <br /> Section No. I.ot Block Subdivision _ <br /> Plat No. <br /> Other Description: <br /> I hereby agree that, in case a permit is granted, all work which shall be done and all m;�terials which shall be used, <br /> shall comply with the City Code of Orono applicable thereto, and shall include all additional specif:cations as listed <br /> below. <br /> �.;: <br /> -� T'�f�1 0�O /vv% f�►���� i<. <br /> Wawr Meur: Fec S / ''= <br /> � o w�'� Ne.tc�S �-o rl.�if.4� Se.�.� •.v y�u �un� <br /> Sewer Hookup:(City) Fee S - (.6�./P (�v /q�� /�,00 k. cl�� �4'►��p �� (N�41ZT1'C. ,�^ <br /> f.�. i: <br /> �''Inttall PlumbIt�g Syauma: Fec S �Y���`'�^' : <br /> , � � <br /> InstaII Seaaga Dispoaal Systema: Fee S Signatu��applican ,/y%/J /� � <br /> / �7 : <br /> �itall Water Hookup:(City) Fee S s� �� �� �'�� � � <br /> Iar'.ail Wa:e�Supply Systems:(WeU) Fce S <br /> SAC Fee 3 Signature o City Offic' ' <br /> State Surtax: Fee S .50 � <br /> i <br /> Total Amouat Pdd to City . . . . . . . . . Fee S f.5��V i:;�y ' <br /> I•*�i <br /> Code:WhitaFile Copy;Cmary-Inspector's Copy;Pink-Finance Copy;Gold:ApplicanY�Ccipt �,: <br /> ��A. <br />� > .. --- -... --�------......�...w,:.�,....:��;�•:mu+.sra4aa'wtirtww,:�:,,.�..... <br /> ...�-__:�.......,w..:-.r..,r .......—_._._--...__ �f <br /> T'L*'R�. ac."'"'w .0 S <br /> .�� .���y.-• <br /> c <br />