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City Permit _N? 5364 <br />Contractor eL+y+•sx so A, �+_ C . Address SPRiNr AP_K_ <br />Owner I-14+ARD PEreEXLsoA! Address 19VO C0064nu. RN_ <br />State License No. <br />Parcel No. <br />City License No. <br />GENERAL PERMIT <br />C1TY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Section No. Lut Block Subdivision <br />Plat No, <br />Other Description: <br />Date /0-12 -713 <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 f <br />Sewer Hookup: (City) <br />Fee S <br />InstaU Plumbing Systems: <br />Fee S <br />Instal Sewage Disposal Systems: <br />�.o <br />Fee S <br />Signature ant <br />Instal Water Hookup: (City) <br />Fee S <br />Install Water Supply Systems: (Wel) <br />Fee $ <br />SAC <br />Fee $ <br />Signature of City Official k <br />- <br />State Surtax: <br />Fee $ <br />OL <br />Total Amount paid to City ... . ..... <br />Fee $ <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />