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City Permit N 8 5617 <br />Contractor Wm/Ki e &es , Address :5eww e,, le-9ielr <br />Owner R ax r .µ C . )Rae -LE Y Address gOS u) �E.eNm4�_ - <br />State License No. <br />Parcel No. <br />Section No. Lot <br />Plat No. <br />Other Description: <br />City License No. <br />GEN'k.RAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 _ZS_ —r79 <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 sha!1 be used, <br />shall comply with the City Code of Orono applicable thereto, and shall include all additional specific.tlons as listed <br />below. <br />Water Meter: <br />Fee S <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 S <br />Install Water Supply Systems: (Well) <br />Fee $ <br />Signature �f_ppl�c t <br />� 'Z� <br />SAC Fee $ Signature cit tt% Oflu al <br />S� <br />State Surtax: Fee $ _ <br />S� <br />Total Amount Paid to City ... . .... . Fee $ <br />Code: White -File Copy; Canary -Inspector's Copy; Pink-Fir.ance Cory; Cold -Applicant's Receipt <br />