Laserfiche WebLink
¢0 City of Orono (0 FOR CITY USE ONLY <br /> P.O. Box 66 T) �1 <br /> t 2750 Kelley Parkway Date Received:l Permit#oC�� q <br /> .13 <br /> ` eO <br /> Crystal Bay, MN 5532SD <br /> 3 <br /> ti (952)249-4600 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 /> W .. <br /> Site Address: <br /> Owner: 4c, ( Mailing Address: ��'`fes w��✓�w'ti1�s <br /> City: Zip: <br /> Home Phone: �!SZ� -7 0 Alternate Phone: <br /> a . w <br /> Contractor/ANN •. �. es S5 Contact Person: <br /> � <br /> Address: 2 3 5f S State License <br /> City: Zip: Expiration Date: <br /> Phone: 7 �`� `�' /2 .2 s�`� AlternatePhone: <br /> „ TYPES OF OCCUPANCY <br /> Residential ❑ Commercial ❑ Other <br /> a. <br /> 'PER 'F tF.E-ES <br /> New or Replacement System $200.00 -2-C-) CD <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total $ 2 O b 5-1,; <br /> V:\(Permits)\Septic Permit Application-New Permit Fees 2009.doc <br /> 1 /2 <br />