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�¢p�,� City of Orono � �� � � �l+r�uSE�t�LY , ;� � � <br /> P.o.BoX ss � , 5 ���� 9 <br /> 2750 Ke�ley Parkway � Date Rece4vefl Perrr�it� � � = <br /> ������ Crystal Bay,MN 55323 ,�:�, ��`���"� + ;; � ° � k �: �� <br /> (952)249-4600 � �Amount�`� `,. $���� �, �`: , ' ,s <br /> U,�� <br /> CITY OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) <br /> Site Address: `��� ��C��-✓ � �C � <br /> Owner: � • t—F =' r U� Mailing Address: <br /> City: (�(�D!U O Zip: <br /> Home Phone: Alternate Phone: <br /> ContractorfApp.: ����C O E X c��/.}-{-,°�G- Contact Person: Rp��-f }Zt�-F�-e.f <br /> Address: _ ��t� 3(^C�IL�ti qJ� �Q State License#: <br /> City: ����� Zip: 5��� � Expiration Date: <br /> Phone: l�J — �.��-,�,2(� Alternate Phone: <br /> Residential ❑ Commercial ❑ Other <br /> New or Replacement System $100.00 /��.U C] <br /> Repair Existing System 50.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total � l � p . �v <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 1 /2 <br />