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City Permit N? 5528 <br />Lt= rt4JN <br />Contractor S71WV07V s W ���— Address 3 20_ Cw_4,_-T7-u1t- w <br />Owner •.Sokm LENrneYe Z.— Address NP <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. Lot Block Subdivision <br />Plat No. <br />Other Description: <br />Date _ J — 11 — 79 <br />7 - Z 3 SE7-4 vo - NeFy sic_2T <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 S <br />Sewer Hookup: (City) Fee S <br />Install Plumbing Systems: Fee $ <br />Install Sewage Disposal Systems: Fee $ _ a LAM.-, <br />/ <br />Install Water Hookup: (City) Fee $ <br />Install Water Supply Systems: (Well) Fee $ <br />SAC Fee $ Signature of City Offici <br />S'v <br />State Surtax: Fee $ <br />Sfl <br />Total Amount Paid to City ......... Fee S ZO <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt <br />