Laserfiche WebLink
.� <br />� <br /> ,¢p� City of Orono FOR CITY USE ONLY <br /> `"O O P.o.Boxss lL <br /> 2750 Kelley Parkway Date Received: � /� Permit#�$'�� 7 <br /> � ;:y''� ,� Crystal Bay,MN 55323 ,� <br /> � ;,- 7�o (952)249-4600 Amount: $�� <br /> <ta�os4: <br /> CITY OF ORONO— SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Buiiding Official} <br /> Job Site / Owner Information: <br /> SIt2 Rdd1'2SS: 205 Hollander Road <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/A JD Excavating, Inc. COf1t8Ct Pei'SOfI: Dianna Beardsley <br /> PP.: <br /> PO Box 48687 l., � !i� � <br /> Address: State License#: <br /> Clty: Coon Rapids Z�P: 55448 Expiration Date: <br /> Phone: (�63)767-4382 .� AIt���Bt� PhOR�: ��63)286-7194 <br /> TYPES OF OCCUPANCY <br /> Q Residential ❑ Commercial � Other <br /> PERMtT TYPE AND FEES <br /> New or Replacement System $100.00 $�oo.00 <br /> Repair Existing System 50.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total � 100.50 <br /> V:1(Pertttits)1Septic System Permit Application.doc <br /> 1 /2 <br />