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Contractor <br />Address <br />City Permit N0 6437 <br />Owner [1D Vy—� C- N I " G:- L L Address f 01 I& IE��T ��t'NOVE _rY <br />State License No. <br />Parcel No. <br />Section No. <br />Plat No. _ <br />Other Description: <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 'I 7 —S7 <br />Date i- <br />Lot 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 />Fee $ <br />Sewer Hookup: (City) <br />Fee $ _ <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee S <br />Signature of applicant <br />Install Water Hookup: (City) <br />Fee $ <br />V�- <br />Install Water Supply Systems: (Well) <br />SAC <br />Fee $ _ <br />Fee $ <br />Se fficiaY <br />State Surtax: <br />Fee $ <br />Total Amount Paid to City ......... <br />vo <br />Fee $ 4 2 s. <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />