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City PermitN? 5857 <br />Contractor C-Lz-a Address <br />Owner Address <br />State License No. <br />Parcel No. _ <br />City License No, <br />GENERAL PERMIT <br />CUY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 Date <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />I hereby agree that, in case a pennit 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 S <br />Sewer Hookup: (City) Fee $ <br />Install Plumbing Systems: Fee $ <br />Install Sewage 14sposal Systems: Fee S Signat e o applicant <br />Install Water Hookup: (City) Fee $ <br />!mall Water Supply Systems: (Well) Fee $ <br />SAC Fee $ Sien-;,,,)� : "tty oft ial <br />State Surtax: Fee $ , SO <br />Total Amount Paid to City ... ...... Fee $ 1;e), Sd <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />