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City Permit No 4963 <br />0001 <br />Contractor eZ _,�,J,. � —e,-Address i aT <br />Owner Address �V Z <br />State License No. City License No. <br />Parcel No, <br />Section No. <br />Plat No. _ <br />Other Description: <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />173-7357 <br />Date /6 —3-7 7 <br />Lot Block . Subdivision <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 (lookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />1'� a, pp� <br />Instan ewag bisposal Systems: <br />Fee $ /b . <br />Install Water Hookup: (City) <br />Fee $ <br />Install Water Supply Systems: (Well) <br />Fee S <br />Signature of appli nt <br />SAC Fee S Si n of City Oftjr:�f� <br />State Surtax: Fee <br />Total Amount Paid to City .. ..... Fee 50 <br />Code: White-FUe Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />