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City Permit N?5317 <br />Address <br />Address <br />State License No.City License No. <br />GENERAL PERMIT <br />CTIY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Parcel No. <br />Section No.Lot Biock 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 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:Fee $ <br />Sewer Hookup: (City)Fee S <br />Install Plumbing Systems:Fee $ <br />InstaU Sewage Disposal Systems:Fee $ <br />Install Water Hookup: (City)I ce $ <br />Install Water Supply Systems: (Well)Fees <br />SAC Fee S <br />State Surtax:Fees <br />Total Amount Paid to City............... <br />Signature of applicant <br />a- <br />Code: White-File Copy;Canary-lnspcctor’s Copy; Pink-Finance Copy; Gold-Applicant’s Receipt