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City Permit N? 6398 <br />Contractor Address �C <br />Owner &T Ki Address -EZ IJ-DACC <br />State License No. <br />City License No <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 O <br />!date <br />Parcel No. <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <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 />Fee S <br />Sewer Hookup. (City) <br />Fee S �e• �`C <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 />SAC <br />o c. <br />Fee S <br />State Surtax: <br />Fee S S C <br />Total Amount Paid to City .. .... <br />Fee S"Q�C�5101; <br />1 <br />Sigf p liq <br />Si tna'ure of 'ty Official <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />