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� ' � �� <br /> � ��� <br /> � City of Orono FOR C USE ONLY <br /> �4 �� 27 0 Ke le 6 Parkwa Date Received� � Permit�(!�` � <br /> Y Y <br /> ; Crystal Bay MN 55323 �Q� <br /> �e��. .�o} (952}249�600 Amount: � <br /> �aac�4 <br /> CITY OF ORONO-SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager andlo�Building Official) <br /> Job Site/Owner Information: <br /> Site Address: 360 Narth Arm�ad �(,Piv�J� <br /> . <br /> Owner: Tony Lund Mailing Address: 360 Noi�th Road Orono <br /> City: Orono Zj�; 55364 <br /> Home Phone: 6���2_�51-2006 Aitemate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: Marty ' s Excavating,LLC ContactPerson: Marty Ziermann <br /> Address: 7185 xutz Lake Road State License#: 768 <br /> City: Mayer Zip: 55360 Expiration Date: 3/05/2015 <br /> Phone: 952-657-2548 Alternate Phone: 6'1�2-868-0581 ceii <br /> TYPES OF OCCUPANCY <br /> � Residential ❑ Commercial ❑ Other <br /> PERMlT TYPE AND FEES <br /> New or Replacement System $200.00 $200.p0 <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> State Surcharge 5.00 5.00 <br /> Total $ $205 .p0 <br /> W:1(Permits)1Septic Permit Application-Updated Surcharge 7-1-10.doc <br /> 1 /2 <br />