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- . �,�� <br /> ,ti <br /> O� City of OrOno � FOR CITY USE ONLY <br /> P P.O.Box 66 -7 <br /> 2750 Kelley Parkway Date Received: �' / "" �7 <br /> .� �, Crystal Bay,MN 55323 Permit# v,0 �7— �(� �3 � <br /> s� �. Phone:(952)249-4600 <br /> �'�krs�io0.� Fax: (952)249-4616 Approved By: <br /> 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 /> Job Site / Owner Information: <br /> , : _ <br /> Site Address: V�j v 5'�1 � , <br /> , <br /> Owner: ��,,.4.--, s"., �•-�-U�7 Mailing Address: <br /> CitY� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Appticant Information: , !� <br /> : � < <br /> Contractor/App: � � � , S ��'Y, Contact Person: �-�-�"� <br /> Address: �Z. �v� S�;-- S-� s � State License #: L ���� <br /> City:`'�rry,�-� ;--�� Zip: S�3��j Expiration Date: 2 �/ � <br /> Phone: 7 �� 5' - `/�7 � - �7�°2 Alternate Phone: ��� � �:�5 `15`� <br /> TYPES OF OCCUPANCY <br /> �] Residential ❑ Commercial ❑ Other <br /> ** ATTENTION APPLICANT ** <br /> Fill in all a ro riate blanks and check all a ro riate boxes. <br /> Tanks: <br /> �Q Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other: <br /> J � Number of Tanks: � <br /> , % <br /> Size of Tanks: � Z S� er�..r,j'a�, � Sc;�� �, �� <br /> Type of Activity: <br /> , ,� <br /> ❑ Trenches �.{�] Mound ❑ Pressure Bed ❑ Chambers ❑ Holding Tanks <br /> ❑ Pre-Treatm�nt ❑ Other <br /> NOTE: Provide an As-Built af the system before the final inspection. <br /> A 24-HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. <br /> Page 1 <br />