Laserfiche WebLink
��v <br /> . . ,�� <br /> � <br /> city of orono REC�IV�D FOR CITY USE ONLY � <br /> ��N� P P.O.Box 66 �,�Q'� 0 <br /> 2750 Kelley Parkway SEP 2 6 2016 Date Received: <br /> ,, Crystal Bay,MN 55323 Permit# �~' � <br /> Z,� �'� Phone:(952)249-4600 �° '� " <br /> ��krsHoa� Fax: (952)249-4616 Approvec!By:; � <br /> CITY OF ORONO Amount$: <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 /> Site Address: �-t J �� �� � �' ��� �� ' <br /> Owner: ��✓`�n ���� MailingAddress: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/A : G�, -�S s�5 Contact Person: V� <br /> PP �— <br /> Address: State License #: ___�(o `�0 <br /> City: Zip: Expiration Date: Z1'J( <br /> Phone: �'��,�,_-�7 � �7.6 Z� Alternate Phone: ��Z- ��� �1 �1 <br /> �Residential ❑ Commercial ❑ Other <br /> Tanks: <br /> �Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other: <br /> Number of Tanks: 3 <br /> Size of Tanks: �, C�U ���� I � G L� <br /> Type of Activity: <br /> ❑ Trenches Mound ❑ Pressure Bed ❑ Chambers ❑ Holding Tanks <br /> ❑ Pre-Treatment ❑ Other <br /> NOTE: Provide an As-Built of the system before the final inspection. <br /> A 24-HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. <br /> Page 1 <br />