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City Permit N8 5021 <br />Contractof ''� `� " Pik .l O ZI Address Ltd S O / [ �c�t i `�" , / -S lPge `,` `� <br />Owner ram+.-,,/ j ,�t,, Address 3 <br />State License No.1 Yc' q /1i City License No. <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />GENERAL PERMIT <br />Cl'i'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 % Date �1 3 <br />_ <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 />ei <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />si lure of op licant <br />Install Water Hookup: (City) <br />ryi i') 1 <br />Fee S <br />Install Water Supply Systems: (Well) <br />Fee $ <br />SAC <br />Fee $ <br />Signirttirc of City Official <br />State Surtax: <br />Fee f 0 •�' =� • <br />� '' --i� 1 �4'= f' <br />Total Amount Paid to City ......... <br />Fee S 1 �l <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Cold -Applicant's Receipt <br />