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City Permit N? 6279 <br />Contractor + OC16L A s w E U-L Address _ � K A <br />Owner 'e, Co "S*T . AddressFAKVl ew <br />State License: No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No. <br />GENERAL PERMIT <br />GTI�Y OF ORANO <br />Crystal Bay, Minnesota <br />473-7357 33- <br />Date <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 />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems• <br />Install Water Hookup: (City) <br />[no" Water Supply Systems: (Well) <br />Fee S <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee 3 �270, <br />Signature of apptican-tt�/%� -- <br />SAC Fee $ Signature of 'ty official <br />l/ <br />State Surtax: Fee S .S0 Q <br />Total Amount Paid to City ......... Fee $ .LU 5 U <br />Code: White -File Copy; Canary-lnapector's Copy; Pink -Finance Copy; Cold -Applicant's Receipt <br />