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PERMIT <br />CITY OF ORONO PERMIT TYPE: <br />2750 Kelley Parkway - P.O. Box 66 {,EES &WATER <br />Crystal Bay, Minnesota 55323 Permit Number: iit) rF <br />(612) 473-7357 Date Issued: 06/ 16/95 <br />SITE ADDRESS: <br />27:35 COUNTRYSIDE DR W <br />L'_:V <br />P. I N. , 04-11-/-2:-:- 1 <br />DESCRIPTION: <br />INE_W ;EF 1_ C: SYSTEM <br />Sewer b Water Permit. Type NEW SEPTIC SYSTE <br />Sewer °•I Water W•:,r;.: Type kEL:IDE NC:E <br />REMARKS: <br />FEE SUMMARY: <br />Base F�-.r $1()().0t► <br />cLlrc'harq�' --- - �� <br />II-Ital F :�. 1Cii::.50 <br />CONTRACTOR: - Applicant - <br />C:LriVtl. HILL COMPANY TNC: S72%371S <br />8 0 X 2�:h <br />'_:HAK" IEEE MN 55.179 <br />(. 61 ') 72:3-715 • <br />IL <br />am <br />Arfm <br />:00.00 _- <br />OWNER: <br />I.INY E: I DEN COMPANY <br />27:35 COUNTRY' ;DE DR W <br />I-IRI_INCI MN 66379 <br />THE:: UNDERSIGNED HEREBY REQUE'3TS PERMI'3SICIN TO MAk:E TEE REAL !1'IF•-."0VEMENT':: <br />SPECIFIED AND AGREES TO 00 ALL W1 --IRK IN STRICT COMPLIANCE WITH ALL CITY OF <br />CIRONG ORDINANCE,,--; AND ':.TATE: CIF M I NNECd-IT A BUILDING CODE RE0U I REMEiNT' . <br />APPLICANT PERMITEE SIGNATURE <br />C'� Lz',t�� L <br />ff ISSUED BY SIGNATURE <br />JI <br />