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City Permit N? 6217 <br />Contractor W L s Address -r 6 <br />Owner Addressrl <br />v <br />State License No. City License No. <br />Parcel Nc,. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />GENERAL PERMIT <br />CPi'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date_. - 9 CFO <br />Block Subdivision <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 />Wa':'Meter, Fee $ <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: (City) <br />Install Water Supply Systems: (Well) <br />Fee $ <br />Fee f <br />Fee $ <br />Fee $ <br />Fee f <br />SAC Fee f Signature of City ICU <br />State Surtax: Fee $ .50 <br />Total Amount Paid to City ......... Fee $ &0 - 5 O <br />Code: White -File Copy, Canary -Inspector's Copy; Pink -Finance Copy; Gold-Appl;cant's Receipt <br />