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City lertttitN? 5298 <br />Contractor Al— P.MgM t/ Address SPa/m, p,Ase e! <br />State License No. <br />City License No. <br />GENERAL PERMIT <br />CTrY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 <br />Parcel No. <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date g- 29- 7e <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: pity) <br />Install Plumbing Systems: <br />well Sewage Disposal Systems: <br />bnstaa water Hookup- (City) <br />Install water Supply Systems: (well) <br />SAC <br />Fee S <br />Fee S <br />Fee S <br />Fee S_ <br />Fee $ <br />Fee S <br />Fax S <br />3-0 <br />State Surtax: Fee $ <br />lTotal Amount Paid to City ......... Fee S �_ <br />Signature of City tcial <br />Code: W12100•Fae Copy: Canary -Inspector's Copy; Pink -Finance Copy; Coid•AppticanC, Reoeipt <br />