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City Permit Na 4831 <br />Contractor �4� Address <br />Owner Address - <br />State License No. ----City ► icensc No. — <br />GENERAL PERMIT <br />CITY n1%.Y%P ORONA O <br />Crystal Bay, Minnesota <br />473-7357 <br />Parcel No <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />1�-le, •?i <br />Date___ WI— /41— 7 <br />hereby agree that, in case a permit is granted, all -work which shall be done and all materials which shall be used, <br />shall 7omply with the City Code of Orono at; licable thereto, ant: shall include all additional specifications as listed <br />below. <br />Water Meter: Fee $ <br />Sewer Hookup: (City) Fee $ _ <br />install Plumbing Systems: Fee $ <br />Insta.l Sewage Disposal Systems: Fee S _ applicant <br />Install Water Hookup (City) Fee S <br />Install Water Supply Systems. (Weil) Fee S _ ' � • O <br />SAC Fee $ Signat - of City O^ffic ,. �, <br />State Surtax: Fee $ <br />Totsi Amount Paid to City ......... Fee $ z0 5-0 <br />Code: Whit&File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />