Laserfiche WebLink
I SEPTIC SYSTEM INSTALLERS <br />LICENSE application <br />J <br /># <br />CITY of ORONO <br />(612) 473-7357 <br />Post Office BOX 66 <br />Crystal Bayr MN 55323 <br />All questions must be ^ttache^^^lf <br />ffi=atlonrlrrs^"b"jlc\\^o “a"«n"aot day approval period. <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />Business phone -3 79Residence phone <br />Name of applicant^r <br />certification <br />any representative holding MPCA <br />Q _________ ' —------------------------------- <br />»pyp0 of CBirtiif 1 cation h©ldj <br />Certificate expiration date <br />•^^j^Installer <br />/ T-/ ^ / 9^^ <br />Pumper <br />year <br />Have you ever had a license revoked? "’’a"' <br />Where? <br />Do you do Municipal Sewer hook-ups? Yes No <br />9. Do you pump out septic tanks? Yes <br />SUBMITTALS REQUIRED: <br />No <br />rTTv r.r “fvtiv.n <br />FUSANCE CFFICt <br />1311500000 <br />01 OEti •c: . <br />^ k/ • V <br />nC <br />fISiS 00 Uce^fairpe^it b"ond naming City of <br />^ ib?io;e Thflta^e Plumbers Bond will not be accepte|^,/Jfci ^QljlX3 IsO-folllOO,000 minimum certificate of In^rance.g^Sif^^ O.A <br />copy of current MPCA Certificate. e,p. <br />licehshs will not be processed ontil all items are submitted <br />ii. ar^r>licant who are authorized by yo4 to applyList persons other than applicaj^ wno _ _ <br />for permits under your license ,7^.- - - -'7^'^ -- - - - - <br />The undersigned hereby applicet^o"^ t^th^ <br />Minnesota, for a to ^ the^laws of the State of <br />and/or pump out septic tanks, orono. <br />Minnesota and the Ordinances of the ot ^n°- <br />Date -l// -i-/ 9 -Z- Applicant's stanature <br />:iTY <br />35E <br />DNLY <br />Reason for denial: ---------- <br />City Council Action Date <br />Date license mailed _ _ _ <br />Date ^ <br />Approved