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Contra <br />Owner <br />e_1__.1 <br />Address <br />Ad dress <br />City Permit Na 5288 <br />U <br />State License No. City License No. <br />GENERAL PERMIT <br />CM OF ORONO <br />Crystal Bay, Minn -.sora <br />473.7357 <br />Date <br />Parcel No. <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 />Water Meter: Fee $ <br />sewer Hookup: (( ity) lee S <br />Install Plumbing Systems Fee S <br />Install Sewage Di4N)sai :;ystr _ ! ee $ signature of applicant <br />Install Water Hookup: (City) I ee S — <br />Install W'wet Supply Systems (Well) ! ee $ <br />SA( ! ee S St mt urc City Uff I 1A <br />State S U f t it t U ee '� I �l� --�-_......_ _�----•-... <br />Total Amount Paid to (Ity ) rt( � * <br />Code White -title ((►pr,t angry lnsl���t,�r'� ( �111V Pink I Enarii.r ( (PV Gold Applie.antRe.-eIpt <br />