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i * <br />J <br />CITY OF ORONO <br />(612) 473-7357 <br />2750 Kelley Parkway, P.O. Box 66 <br />Crystal Bay, MN 55323 <br />11 H cf.cNO j <br />SEPTIC SYSTEMINSTALLERS <br />LICENSE APPLICATION <br />FEB 2 [4 199S <br />SSion to period. <br />1. <br />I 3*3 3 ly <br />------ ' fcicv* ~I («P) <br />________________________ <br />J. <br />4. <br />5. <br />6. <br />Business or trade name _ <br />'LaoBusiness address_____H---------------—■ (city) <br />/ f'y <y - *7*5^*^ Residence phoneBusiness phone V 4. o____: ------— <br />Name of app.icam or company r^i^eotanv-efs) bolding MPCA cer.inca.ion <br />_____________c ------------------------------------------------------------------------------------------- <br />Type of ccrrir.ca.ion held:X,I'«“>'« - <br />Have you ever held a Sep.ic Sys.em Insraller license in Orono before? <br />Most recent year ----------- <br />/. <br />Have you ever had a license revoked? When. <br />Where? <br />8.Do you do Municipal jewer hook-ups? Yes <br />rrry -rLift u*i w; wi nV.* <br />•*“ J, I I’fT*"U.- w»“ “ -i I- U <br />i X w*V VW'V ... <br />.. 01 u-v <Uj>K <br />L i'ltiS iL, Z'<•••.■ <br />>tv.=309000 cool <br />9. Do you pump out septic tanks? Yes ----- <br />SL^MITTALS REQUIRED: <br />1. $50.00 License application fee. ^v., omnn at oblioee The State Plumbers <br />17^2. S2.000.00 license and permit bond narmngCity of Orono as oblige . <br />Bond will not be accepted. ^^.^■'51 , /'y^— <br />3 $50-100-300,000 minimum Certificate of Insurance. <br />^ "4 Copy of current MPCA Certificate. <br />UCE.NSES WILL NOT BE PROCESSED UNTIL ALL ITEMS ARE SteMirTED <br />List persons oriier than applicant who are audiorized by you to apply for permiB^cc your hcense <br />s 2:* £ irsrs <br />and the Ordinances of the City of Orono. <br />___Da.e_Ji^251--------- <br />I • • ' .• . <br />\/iUf lb <br />CITY <br />USE <br />ONLY <br />Staff recommendation: Approval <br />Reason for denial:_____ <br />City Council Action: Date <br />Date license mailed_____ <br />Approved Denied