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City Permit N? 4712 <br />J� <br />Contractor � �/� Address /�D <br />Owner 4� Address %`/5O9 xa-e <br />State License No. City License No. _ <br />GENERAL PERMIT <br />CITY OF ORONO <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />Crystal Bay, Minnesota <br />473-7357 <br />Block Subdivision <br />Date <br />6 — 74 <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: Fee S <br />Sewer Hookup: (City) Fee S <br />Install Plumbing Systems: Fee $ <br />i <br />Install Sewage Disposal Systems: Fee $ ___S+ttwatm�T applicant, <br />Install Water Hookup: (City) Fee S <br />Install Water Supply Systems: (Well) Fee $ 119.00 <br />SAC Fee S Signature o Cit •• Of <br />State Surtax: Fee $ So <br />Total Amount Paid to City ......... Fee S do , S O / <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />