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City Permit.TO 5402 <br />Contractor ST-OD O L A tA 1 Et-L Address z c),: f 1wY / k-\7*4 <br />Owner AN ,—,W 6-bcsrr' Address / 3 s- F�X Sz-. <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 />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />Block Subdivision <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which :iall be used, <br />shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed <br />below. <br />1./D A p—/ LC (�Eb W�zM 1� <br />Water Meter: <br />Fee $ <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal S;-stems: <br />Fee $ <br />_ <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee S <br />Fee S <br />CIO <br />State Surtax: <br />Fee $ <br />' 41) <br />Signature of applicant <br />Signature of City ffici <br />Total Amount Paid to City .. ..... . Fee S1� <br />Code: White -File Copy; Canary inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />