Laserfiche WebLink
City of Orono ��y����p FOR CITY USE ONLY <br /> �ONO P P.O.Box 66 <br /> 2750 Kelley Parkway Date Received: — G — �� <br /> a , Crystal Bay,MN 55323 MAR 3 0 2017 <br /> y� 4: Phone:(952)249-4600 Permit# �l�—�� �.�/ <br /> ��krs�ioa� Fax: (952)249-4616 Approved By: <br /> �►'ITY 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 /> Job Site / Owner Information: <br /> Site Address: � �U � �/ v t, L�;j��-e, ��� , <br /> Owner: /'�,'oy���,-,-, �; ;�v�,�S Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> �ontractor/Applican#7nformation: <br /> Contractor/App: �-�i��,2� ^`�'��� Contact Person: 'Z' <br /> Address: Z-C;� 3 �� S f �� State License #: � ZO `� <br /> City: ���,�-�vt�c�-e Zip: �-�'� Expiration Date: 7 � ( <br /> Phone: 7 � �����– ��C �� Alternate Phone: ��� ��.�� I� <br /> TYPES OF OCCUPANCY <br /> � <br /> [�Residential ❑ Commercial ❑ Other <br /> / <br /> ** ATTENTION APPLICANT ** <br /> Fill in all a ro riate blanks and check all a ro riate boxes. <br /> Tanks: <br /> �Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other: <br /> Number of Tanks: <br /> Size of Tanks: � Z 5 C� s,o�i � — / �� �) �� '�'�� <br /> , <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 />