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, , ,\� <br /> �\� <br /> �ONO P P O�BoOx 66 no � R�C�IVED FOR CITY USE ONIY <br /> ` 2750 Kelley Parkway Date Received: —�—�� <br /> ' ,\, � Crystal Bay,MN 55323 JUN 0 5 Z�17 Pertnit# d � �- <br /> Phone:(952)249-4600 , � <br /> \e��-`.�`^ Fax: (952)249�i616 APproved By: <br /> CITY OF ORON() Amount s: DU <br /> CITY OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building OfFcial) <br /> Job Site / Qwner Information: <br /> Site Address: ;' ,C' �;�ir��C� ��..'�,� ,/� ���a �� � <br /> Owner: Mailing Address: `�f� /»C <br /> City: ���1��C� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: �, <br /> ,-- <br /> Contractor/App: �'7��--�' �-=�L�.S'C� ntact Person: L/ / � <br /> Address: State License #: c�?/ �` <br /> City: Zip: Expiration Date: <br /> Phone: 7�F�3 J j �� � � -��-,�1� Alternate Phone: <br /> TYPES OF OCCUPANCY <br /> � Residential ❑ Commercial ❑ Other <br /> ** ATTENTION APPLICANT ** <br /> Fili 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: % — ��7.5 �� / -- /OhC> <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 />