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I <br />r <br />> <br />L <br />City Permit N9 4943 <br />Contractor <br />^ Owner KeA/ ______________ <br />Address <br />, Address o29c3fr fo yC. ST"._________ <br />State License No.City License No.. <br />GENERAL PERMIT <br />OTY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date.7-/5--77 <br />Parcel No_____ <br />Section No____________Lot.Block.Subdivision. <br />Plat No. <br />Other Description: <br />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />InstaU Water Hookup: (City) <br />Install Water Supply Systems: (Well) <br />SAC <br />State Surtax: <br />Fees <br />Fees <br />Fees <br />Fee S > <br />Fees______ <br />Fees______ <br />Fees______ <br />QCJ <br />i <br />il <br />i <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 />r <br />I <br />Signati^ cf applicam jj J <br />Fee S , S<^ <br />ToUl Amount Paid to aty....................Fee S <br />Code: White-File Copy; Canary-Inspector’s Copy; Pink-Finance Copy; Gold-Applicant’s Receipt <br />Signature of City OffidaK ^ <br />/ i. ^ 1 A t