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City Permit N? 6193 <br />Contractor �.1/ 7XX�1/i�� Address <br />Owner Address O <br />State License No. City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 <br />Parcel No. <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date A, <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 S _.. <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee $ <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee S <br />Signature of pplica t i <br />SAC Fee $ _ Signa City Official C�✓ LJ <br />State Surtax: Fee $ <br />Total Amount Paid to City ... ..... . Fee $ �C • s0 ' <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />