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City Permit N? 5437 <br />Contractor .SNLL / VAAJ 5;� Vic E e Address /may /0 % <br />Owner&&J,.Z,2 Address � Z' <br />State License No. <br />Parcel No. <br />City License No, <br />GENER<111L PERMIT <br />CPl'Y OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Section No. Lot Block Subdivision <br />Plat No, <br />Other Description: <br />Date lyl::� /7 <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 Mater. Fee S _ <br />Sewer Hookup: (City) Fee S _ <br />Install Plumbing Systems: Fee S <br />ao .� <br />Install Sewage Disposal Systems: Fee S tgnat applic t <br />i <br />Install Water Hookup: (City) Fee S <br />Install Water Supply Systems: (Well) Fee S <br />SAC Fee $ Signature o[ City ficial <br />State Surtax: Fee S <br />Total Amount Paid to City ......... Fee S <br />Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />