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City of Orono FOR MY USE ONLY <br /> P P.O.Box 66 , `�f <br /> 2750 Kelley Parkway �i( /til Date Received: r —��—�/ <br /> Crystal Bay,MN 55323 ` I PermR# / [� <br /> Phone:(952)249-4600 <br /> keslioRj' Fax: (952)249-4616 ApproveJ <br /> _ Amount <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 /> Job Site/Owner Information: <br /> Site Address: /���� — Z_ 19 z_ <br /> Owner: -A ming Address: <br /> City: 0/'C-Z2 ,4 D Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant information: <br /> Contractor/App: XS &if,_ -7-1267_514�?5 AlContact Person: <br /> Addr ss: 9 a �� (,( yg V45 State License #: /y <br /> City:7F_z'q Zip: Expiration Date: <br /> Phone: 7 Alternate Phone: <br /> TYPES OF OCCUPANCY <br /> Residential ❑ Commercial ❑ Other <br /> ate boxes. <br /> lis � <br /> ] Holding Tanks <br /> all inspection. <br /> A 24-HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. <br /> Page 1 <br />