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� City of Orono FOR CITY USE ONIY <br /> � ��, P.O.Box 66 <br /> �., � � 2750 Kelley Parkway Date Received: � � � Permit# aDD�—� 7(0 <br /> `� t�� ��.; �,� Crystal Bay,MN 55323 Amount: $ a��•� <br /> ���ob�� (952)249-4600 <br /> R�cE��F <br /> CITY OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION s�.P D <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) , <br /> ��� �?009 <br /> �F�RO <br /> Job Site / Owner Information: NQ <br /> Site Address: <br /> 3405 High Lane Orono, MN. 55356 <br /> OWI1er: Kevin & Denise Reilly Mailing Address: 3405 High Lane <br /> Clty: Long Lake Z�p: 55356 <br /> Home Phone: �952)475-4043 Alternate Phone: <br /> Cantractor/'Applicant Infarmation: <br /> ContraCtor/App.: Burns Excavating, Inc. Steve Burns <br /> Contact Person: <br /> Addr2SS: 3470 County Road 21 State License #: 1888 <br /> City: Mayer Z�p: MN Expiration Date: 03/2���0 <br /> (952) 955-3112 AIt2Cllat2 Ph0112: �612)685-4303 <br /> Phone: <br /> TYPES OF OCCUPANCY <br /> ❑✓ Residential ❑ Commercial ❑ Other <br /> PERMIT TY�'F'�iWC1 FEE�` <br /> New or Replacement System $200.00 $200.00 <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total � 200.50 <br /> V:\(Permits)\Septic Permit Application-New Permit Fees 2009.doc <br /> 1 / 2 <br />