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City Permit N? 6153 <br />Contractor <br />Address �— l <br />Owner Address <br />State License No. <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />CITY OF OR,ONO <br />Crystal Bay, Minnesota <br />473.7357 /LO <br />Date !' <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 />Water Meter: <br />Fee $ <br />Sewer Hookup: (City) <br />Fee $ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee $ <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) Fee <br />Si a of applica <br />SAC Fee $ Sig t City Official <br />State Surtax: Fee $ . St� <br />Total Amount Paid to City ......... Fee S S-10 �f <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />