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City Permit N? 6514 <br />Contractor L ti 0- <br />-bb�, So ti S <br />Address Lo Nt; <br />h _ <br />_ <br />Owner <br />Address 10 4� L�/ <br />�E2f�A �E <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 />Ch Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 �� a _ I <br />Date _-- . <br />Block Suhdivision <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 lookup: (City) <br />F'ee S _ <br />Fee <br />Fee S <br />Fee S <br />Fee S <br />Install Water Supply Systemr: (Well) Fee S <br />SAC FeeS Alas.0 <br />State Surtax: Fee S <br />Total Amount Paid to City . ....... . FeeS t <br />Si r f appa�t <br />SignatT54F City Offi <br />Code: White -File Copy: Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />