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Conti <br />Owne <br />State <br />Parcel No. <br />City Permit N? 4797 <br />Address r <br />Address Os <br />City License No, <br />GENERAL PERMIT <br />CI'i'Y OF OFtONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date �- / / % <br />1 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 />SAC <br />Fee S <br />Fee S <br />Fee S <br />Fee S Signatu .+i� <br />Fee S D P s <br />Fee S <br />Fee S <br />State Surtax: Fee S <br />Total Amount Paid to City . .. . . . .. . Fee $ O <br />Sig of it Official <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />