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� n ,�0� Clty Of OCOf10 FOR CITY USE ONLY <br /> P.O.Box 66 <br /> ��,,,,,,�, � 2750 Kelley Parkway Date Received: Permit# <br /> � ��"�-f=. � Crystal Bay,MN 55323 <br /> �����*���;��.$o` (952)249-4600 Amount: � <br /> �+e��o <br /> CITY OF ORONO - SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) <br /> ���Job Site / Owner lnformation: ��<��w = �� � � <br /> � � , <br /> Site Address �S _> C%'(:i (� �� ��� / <br /> Owner: i���l���-, /� ��r�K Mailing Address: S ��� <br /> City: �r�c�� v Zip: <br /> Home Phone: C �� <br /> , �.� - ��:�� - L O � 3 Alternate Phone: <br /> Contractor/ Applicant Information: <br /> � � <br /> Contractor/App.: ��r�J���a�f �� 5o.tis Contact Person: J � �� <br /> Address: �3��� ( U l T-� ��'��, State License #: � S -�� <br /> City: (�� �c 2S Zip: 5���� Expiration Date: l I <br /> Phone: ��C� - �-f��' - 7_���� Alternate Phone: �C � �� - �(G�`�- ��l�l <br /> TYPES OF OCCUPANCY <br /> Residential ❑ Commercial ❑ Other <br /> ` ` PERMIT TYPE AND FEES <br /> c)f� <br /> New or Replacement System ,$1 . _ ,� ��<^% <br /> Repair Existing System 50.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total $ <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 1 / 2 <br />