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_________/ / <br />CITYM OKONO <br />(612) 473-7357 <br />Post Office Box 66 <br />Crystal Bay, MN 55323 <br />SEPTI'^ SYSTEM INSTALLERS <br />LICENSE APPLICATION <br />crystal Bay, MN 5 License fee, bond, certificate of <br />All auestions must be i«tion must be attached. <br />M m ^ w mi <br />1./>?J <br />***<- <br />■ ss or t-ade nameBusiness or t-aae . <br />^S' S- - -Business address __/0 giA—^2 U <br />Business phene 2Lb2i^J- - - Residence phone <br />Marne of <br />-gr'*-ification jy/OiL)iS j <br />. hsmld* ^ installerof certification held^ - <br />certificate expiration date <br />Have you ever held a <br />Orono before? .diu— ^ <br />X_ _ Pumper <br />8 <br />Have you ever had a license revoked. <br />VJhere? __ _ _ _ _ _ _ _ _ _ _ <br />Oo you do Municipal Sewer hook-ups? Yes <br />DO you pump out septic tanks? Yes <br />A When? <br />No <br />No <br />X-iin CF OFOflO <br />FU;^^CE OFFICE <br />SUBMITTALS REQUIRED: <br />i Ja iw-v vi/vv,-vj rruV* i cu i t <br />rLT-ir T1 <br />W'V' <br />50 <br />;iCL£L''T-f».yi <br />‘=°P5^ curren SUBMITTED <br />^BXCHRSES Wiix MO. SR PROCBSSHO OM.i. - ^ou to apply <br />ermits under your iicen:>« City of Orono, <br />The undersigned hereby makes appUcat^ron to =5^ atfo^ <br />Minnesota, fora ” subject to the laws o. the <br />and/or pump °“= ®®P,Htnlnces of the City of Orono.Minnesota and the Ordinances o u n -J , t! <br />2nd/or pump of the City of Orono <br />Date . Applicant • s signature <br />Staff recommendation Approval <br />Reason for denial: --------------------- <br />City Council Action Date <br />Date license mailed- - -- <br />Denial <br />Approved _