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4� � <br /> City of Orono c��Tt+ iY <br /> U� <br /> P.O.Box 66 � <br /> ��� 2750 Kelley Parkway Date Reoei�red: � /� Pee�ait# ��� p� <br /> Crystal Bay,MN 55323 �''���1 QG� <br /> � <br /> (952)249-4600 Ar�c�d�t: a T�- � <br /> �� �� <br /> G <br /> t'kESH�4w <br /> CITY OF ORONO—SEPTIC SYSTEM PERMIT APPLICATION <br /> (All peRnits must be approved by tlie On-Site Septic Manager and/or Building OfRcial) <br /> w <br /> Site Address: `i Z� �.C,� �c.e-v ��� K.� <br /> Owner: 1�c��`�� ����- Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> ContractorlApp.: � �S �"S cM5 Contact Person: �� <br /> Address: Z� `3 �-� 5 h� S� State License #: L (Q �� <br /> City: /�`��� Zip: Expiration Date: 1 z � �'� <br /> Phone: � �Z �� ��� Alternate Phone: ? � � ''`� ��'�l �� '� <br /> ���d�� � , � �� y � <br /> �,. �,� ��: � <br /> Residential ❑ Commercial ❑ Other <br /> H;�� ���x <br /> New or eplacement System $400.00 ( �� <br /> � <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) � <br /> Total $ r �� <br /> 1 /2 <br />