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City Nrtttit N® 5777 <br />Contractor SraP Wei L- Address #wy 7 M rKA <br />Owner e&p W HVWA4E2tnt Address 7--2-q0 pe-ViN 1AA)E <br />State License No. <br />Parcel No. <br />City License No <br />GENERAL PERMIT <br />GTI'Y OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 Date /Q _ 1 9 - 79 <br />Section No. Lot 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 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 />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S Signature of applicant <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee $ <br />SAC Fee f S' afore of ' y tcial <br />.ro <br />State Surtax: Fee $ <br />Total Amount Paid to City ......... Fee $ 2,12 <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />