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City PermitN? 5161 <br />Contractor .�� o �,A ELL Address 1.S 0 L #LA2 7 _ <br />Owner R�3_CE:1"% Address 3C��,�7 FA,eVl�w <br />State License No. <br />City License No. <br />GENERAL PERMIT <br />CPI'Y 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 _";_ — /e ` 76 <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 />TO <br />Water Meter: <br />Fee $ <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S Signature of applicant <br />Install Water Hookup: (City) <br />Fee S <br />Install Water Supply System: (Well) <br />64, <br />Fee S <br />SAC <br />Fee S Signature of City Of cia <br />Surtax: <br />Fee $��� <br />ILIState <br />�` <br />Total Amount Paid to City .... .... <br />. Fee $ L— <br />Code: White -File Copy; Canary -Inspector's Core; Pink -Finance Copy; Gold -Applicant's Receipt <br />