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City Permit _N? 6061 <br />Contractor �„F.P Address / <br />Owner Le —A Address 447 � rt, I-C • LA UQt kJC; <br />State License No. City License No. _ <br />GENERAL PERMIT <br />CHY OF ORONO <br />Crystal Bay, Minnesota <br />473-7357 <br />Date <br />t <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: <br />Fee S <br />Sewer Hookup: (City) <br />Fee S <br />Install Plumbing Systems: <br />Fee $ <br />Install Sewage Disposal Systems: <br />Fee $ Signature of applicant <br />Install Water Hookup: (City) <br />Fee $ <br />2o. <br />Install Water Supply Systems: (Well) <br />Fee S <br />SAC <br />Fee S City Offict d <br />�U 10 <br />State Surtax <br />Fee S i <br />Total Amount Paid to City . ... .... <br />. Fee $ G, <br />Code: White -File Copy; Canary -Inspector's <br />Copy: Pink -Finance Cop) : Gold -Applicant's Receipt <br />