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PERMIT <br /> CITY OF ORONO Permit Number: <br /> 27-0 K �Iley Parkway - PO Box 66 P063�1 <br /> Cry�tal�ay, Minnesota 55323 Permit Type: septi� <br /> (95�) 249-4600 Date Issued: 6�2�2003 <br /> SITE ADDRESS: 665 Ferndale Rd N <br /> Wayzata,MN 55391 <br /> P I D: 3 6-118-2 3-11-0003 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Pernut Class: General <br /> Permit Type: Septic Permit Sub-type(s): New Septic System <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Pernut Fee: $ 100.00 Valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> TOTAL FEE: $ 100.50 <br /> APPLICANT: Ouverson Excavating OWNER: Franciscus&Gillame Bastiaens <br /> 252 36th Street S.W. 665 Ferndale Rd N <br /> Montrose,MN 55363 Wayzata MN 55391 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> M SOTA BUILDING CODE REQUIREMENTS. <br /> _��� � ��� - <br /> ,� t/�- c.�Y1<�`�� ��� <br /> APPUCANTPERMITE SIGNATURE [SSUEDBYSIGNATURE <br /> Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Revorts, 1-Assessine, 1-Finance Page 1 <br />