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p City of Orono
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<br /> '�� P.O.Box 66 FOR CITY USE ONLY
<br /> �',� T 2750 Kelley Parkway t�
<br /> +iyl S Crystal Bay,MN 55323 Date Received: a — /C ' //
<br /> ' �''� Phone:(952)249-4600 Fax:(952)249-4616
<br /> .'a� Permit Number 2._C%I/:— Cr z',3 (4,
<br /> www.ci.orono.mn.us
<br /> Permit Fee: lamp. 1-Dri c,IL ?/ 7/
<br /> CITY OF ORONO - TENT PERMIT
<br /> (All tent permits must be approved by the Fire Chief)
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<br /> Date of Event: SEPT, 3 101) Size of Tent(s): (pO it.1 ZA' Number of Tent(s): 1
<br /> Does the tent have sides? No Yes
<br /> Please include Fire Retardant Information from the rental company for tent(s)AND a Sketch
<br /> or Drawing of where the tent will be located on the property along with this application.
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<br /> Site Address: 4045 vvAcTERTO v3 t fD pFpik,/ v a 5-- -S9
<br /> Owner: C(' ' PPcNtc Mailing Address: '0 U; -1-E,}a o g..1
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<br /> Home Phone: 6�54 4"7 1p —4047 Alternate Phone: ( MC-1 C-"LU;
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<br /> Contractor/App.: L ti Mf x- a -i-contact Person: R Ia.'-:›O0 v'ut..Ic Li_
<br /> Address: 5 e3 L�
<br /> �-� �1�.S
<br /> City: B �OC�.i �0� 1 Zip: MN 5- 4--- 0
<br /> Phone: EIS Z3SE) 65 Alternate Phone: ( 9SZ 3-462 - Q' p z.
<br /> Fax: Email: OtAKet.von. 12,1l C' (1.Q., - 1•1\v\.. C.Dw-
<br /> I hereby apply for a permit and acknowledge that the information above is complete and accurate; that the work will be in
<br /> conformance with the ordinances of the City of Orono and the Minnesota Fire Codes;and I understand this is ly an application for a
<br /> permit and work is not to start without a permit. 1.,'
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<br /> App :lean Sig ature/Date
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<br /> /ermit Approved By: Dae Approved:
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