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Contractor <br />Owner <br />State License No. <br />Section No. <br />Parcel No. <br />Plat No. <br />Other Description: <br />City Permit N? 5104 <br />Address / <br />Address %o` !L11 <br />City License No. <br />GENERAL PERMIT <br />cNY of ORONO <br />Crystal Bay, Minnesota <br />473-7357 / ! — 7P <br />Date <br />Lot 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 />Water Meter <br />Sewer Hookup: (City) <br />Install Plumbing Systems <br />Install Sewage Disposal Systems: <br />Install Water Hookup: (City) <br />Install Water Supply Systems: (Well) <br />1A( <br />State Surte � <br />Total Amount Paid to City ......... <br />Fee $ <br />Fee S <br />Fee S <br />Fee $ <br />Fee S <br />1-1 <br />Fee S " z7t <br />Fee S <br />Fee S� <br />Fee S <br />Signaturkof Cit Offal, 1 <br />Coda: White-Flla Copy; Ctnary-tepedos's Copy; Mak-Finance Copy; Gold -Applicant's Receipt <br />