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City PermitN? 5197 <br />Contractor;! �1L� C� /mot _ . ��/ �i Address <br />Owner s `!�� Address 117Y 4f-��„ <br />State License Na. <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 /j � 7Y <br />Date <br />Parcel No. <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 />1L1 <br />Ly <br />Water Meter: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee S applicant <br />Install Water Hookup: (City) <br />Fee $ I Jiptisrt" <br />Install Water Supply Systems: (Well) Fee S 4i0. <br />SAC Fee S S of City Offi <br />State Surtax: Fee $ 1 SO — «..0, • �� �� .f <br />Total Amount Paid to City . .. . .... . Fees .20• SD <br />Code: White -File Copy; Canary Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />