Laserfiche WebLink
. <br /> O City of Orono ��� ` USE ONLY �D z Q <br /> P.O.Box Kelley66 <br /> Date ReceiveV61 Permit# /S d�2✓u <br /> -410 2750 Parkway <br /> Crystal Bay,MN 55323 <br /> (952)249-4600 / Amount: <br /> $ <br /> 0. (yeljit&pli <br /> l4kEsHOR�` <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: 790 �-C9 �/1 k (',a. k_. C_l)-c/ <br /> Owner: /JA-"- bC)h.r' Mailing Address: <br /> City: O"P70 Zip: <br /> Home Phone: Y/5-2- ---177') Z e- Alternate Phone: <br /> i8.Q' I sii: �' 1 <br /> Contractor/App.: f-I .e.--5-5 �• *rU ' --R17-4-6 <br /> Contact Person: <br /> `� <br /> Address: 2( . '— S t State License #: L '46 <br /> City: A v+vcr ( Zip: 1'76 Expiration Date: lt- jf <br /> Phone: 76 Y 7 (262-- Alternate Phone: {o (2 68S— J.5 <br /> , a >z: -tib ,. Af:; ,.-;'e <br /> Residential ❑ Commercial ❑ Other <br /> New or Replacement System $400.00 '</C9v ' <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> 41 <br /> Total $ 1(00 <br /> 1 / 2 <br />