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CityNrmitN? 5292 <br />Contractor S= pD L,%} Address %S 30 6 iAj Y % <br />p � ! I <br />Owner 1� JDE2IGk L 1>2 9, Address % yy /J • SACO WA) P, - <br />State License No. <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 Date ° Q <br />- 2_1Y _? <br />Section No. Lot Block Subdivision <br />Plat No. <br />Other Description: <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 />Com y 0,0c�- s-rtV_TZ- t -'E7 -Z LZ z ,Pb rn&4-tT 86- sN6r-.l 7rT":b . <br />Water Meter: FCC $ <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee $ <br />Install Water Hookup: (City) <br />FCC S <br />Install Water Supply Systems: (Well) <br />Fee S <br />SAC <br />Fee S <br />S"D <br />Stat: surtax: <br />Fee S <br />_ <br />2O— r <br />Total Amount Paid to City ......... <br />I cc S <br />-Fignatuy of applicant <br />si • tur�wt C'ty ),ri <br />Code: White -File Copy; Canary•lnspector's Copy: Pink -Finance Copy: Gold- Applicani's Receipt <br />