Laserfiche WebLink
T <br /> ,,�1 City of Orono FO CITY USE ONLY <br /> KILN <br /> P P.O.Box 66 /( d� 'i <br /> 2750 Kelley Parkway Date Received>> <br /> Crystal Bay,MN 55323 Perrnit# C�G'� 11— D 14-(p <br /> F I. . Phone:(952)249-4600 <br /> ;1'r11Hoa-8' Fax: (952)249-4616 Approved By <br /> Amount$: <br /> CITY OF ORONO—SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) <br /> -C i n y- "'`{ --._'� F t„Er f-'�,.fit t <br /> li <br /> Site Address: ://(b Z-0 )10 0141A <br /> 41ce-P't .is' P • vi <br /> Owner: -0 0 I Li) j h.4 .V$' Mailing Address: L4 ?if, iO. r(afh pts <br /> City: 0 vw'-..e9 Zip: <br /> Home Phone: Alternate Phone: <br /> ; ver <br /> Contractor/App: , -44- `rte c-FS <br /> v2A 5 Contact Person: (2...�4). <br /> Address: Z4,3 i2. S 4- S t-`- State License #: (____Lo 4.o <br /> City: tro-,-/4?--'-‹ Zip: 55-3 62 3 Expiration Date: 2--2)/, " <br /> Phone: 76 3 ' 'i' ? - / ?(o z Alternate Phone: l Z <br /> -24 j- S.t.,.tkAlla k P_,(L, it W 4 4 . r ':, ' <br /> A,.�r< �, ,� cu.�'a.,..r _.:`,.4.,2 �, �� s -s:-a?tt� ,.ice-�.������,. s�'�Yis,.�s '."�`�+4��e�,i' ' <br /> Residential ❑ Commercial ❑ Other <br /> g((; 44,..% <br /> ` X net ..y �C i'�v r' ` j r $w---20. t�.-- , r t - <br /> it. ri ,d-. ; 3y I C `< <i e r- x',0c.:(...-_,3 <br /> k' io 5 >s� "x <br /> ^.._. .F, ,. ,��,�I� _..i;, � e ., I :i F i : -. � � -;: '4-- k,' e� ec�i.`� P[,� el e`.L� 4 `� "i �.>n <br /> Tanks: <br /> Erecast Concrete ❑ Fiberglass ❑ Plastic ❑ Other: <br /> Number of Tanks: a42255 3 <br /> Size of Tanks: z_2.S7) . Cs4- h c, l /Fr <br /> Type of Activity: <br /> ❑ Trenches Mound ❑ Pressure Bed ❑ Chambers ❑ Holding Tanks <br /> El 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 />