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City Permit Na 5774 <br />Contractor <br />Address <br />�C <br />Owner <br />Address <br />30.s <br />State License No. <br />to <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No. <br />GENERAL PERMIT <br />GTl'Y OF OftONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Block Subdivision <br />Date _ Z/4— 7 / <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 />Suer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee $ s tra <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) Fee $ <br />Sf a of PPHCAA <br />SAC Fee S _ of City Official <br />State Surtax: Fee SO ~ <br />Total Amount Paid to City ......... Fee S ` s� <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />