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PERMIT <br />CITY OF ORONO <br />2750 Kelley Parkway • P.O. Box 815 <br />Orono. Minnesota 55356-0815 <br />(612) 473-7357 <br />SITE ADDRESS: <br />PERMIT TYPE: <br />Permit Number: EWER b WATER <br />, <br />Date Issued: 061=340 /01 /94 <br />507 F ERNDALE RO N <br />LSV <br />�' . I . N. , 36- 11 :- ?-1 ti:--t ?00 <br />DESCRIPTION: <br />NEW SEPTIC SYSTEM <br />S-awer 4 Water Perrnit Type NEW SEPTIC '3Y'3tE <br />= t-wer & Water Wrlrk: Type RF c:I DENC:E <br />REMARKS: <br />FEE SUMMARY: <br />Ease Fee $100.00 <br />parr har4t -------$..��? <br />Total Fee $100. S0 <br />CONTRACTOR: <br />K'C,E:r- R F. A CAVAT 1 NG <br />2640 , 9TH ST <br />21MMFRMAN <br />(61 !) 441-2:353 <br />IL <br />- Applicant. - <br />54412:::S;i <br />Wf:ST <br />OWNER: <br />:_:A:iJAUI <br />�;_, 7 <br />I'I}-;fiNi'I <br />CITY OF UI?Qlp <br />FIWXE OFFICE <br />131 `- <br />rry, 010 100.00 <br />41 ca .9 <br />HAMAD <br />FERNOALE RO N <br />MN Sbr391 <br />THE UNGFRS 1 GNf- D HE:RE8Y RlE QUF :al t: PERM 1 SS 10N TCI MAKE THE REAL IMPROVEMENTS <br />SPEC I F I EO AND AGREES T� i OIj ALL WOO IN STRICT COMPLIANCE WITH ALL CITY 4F <br />CIRCINO URL)JIVNC:F'_: AND '=:'fAlE CIF MINNESCITA R!JU)ING C:CIL>E. REQUIREMENTS. <br />APPLICANT PERMITEE SIGNATURE <br />if (443 - <br />ISSUED BY SIGNATURE <br />