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City Permit N? 5369 <br />Contractor 6 D S H L L► V4.pj Address N A Y hU r <br />Owner 1j'J • Z' I c M IZ-4AN Address /S­6 O FPS' i <br />State License No. <br />Section No. <br />Parcel No. <br />Plat No. <br />Other Description: <br />City License No <br />GENERAL PERMIT <br />CITY OF ORONO <br />Crystal Bay, Minnesota <br />473.7357 Date Aj_ 16 - 7F1 <br />Lot Block Subdivision <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 />,AClI DCA/titf/ r_> <br />Water Meter: <br />Sewer Hookup: (City) <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: (City) <br />Install Water Supply Systems: (Well) <br />SAC <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ 2-0 ture o a lic <br />Fee $ <br />Fee $ <br />Fee $ <br />s-e <br />State Surtax: Fee S <br />Total Amount Paid to City ......... Fee $ <br />Signature of City Official P� <br />Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold-Appiicant's Receipt <br />