Laserfiche WebLink
City of OrFOR CITY USE ONLY <br /> .`ANO PP.O.Box6r ono <br /> 2750 Kelley Parkway Date Received: �1/Z- <br /> C tal Ba MN 55323 <br /> `4f` 1 ~ Ph ne:(952)249-4600 Permit# <br /> 00SM00. Fax: (952)249-4616 Approved By. c t;� <br /> Amount$: W <br /> CITY OF ORONO-SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) ,r <br /> j Job Site /Owner Information: i tftti°t <br /> Site Address: 59' DC \CA C\ �Ck*ThOCJ.- <br /> Owner: Mailing Address: -;OM <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/App: PO. ( JL Acy,r/ _icr_c :), Contact Person: Uiar,rtcx_. <br /> Address: 1SS t - 1(0.-l' IattA2.-, Il.?&. State License#: L aa--1 <br /> City: h`r1, _ Zip: fS5 y Expiration Date: S 131 1 <br /> Phone: -) (o-J 3'(- 02(-{ o� 1 Alternate Phone: <br /> CCUPA <br /> Residential ❑ Commercial ❑ Other <br /> " ATTENTION APP <br /> FiII in all appropriate blanks and check all appropriate boxes. <br /> Tanks: <br /> X Precast Concrete ❑ Fiberglass I I Plastic ❑ Other: <br /> Number of Tanks: a - 2) <br /> Size of Tanks: 1(2 )C < CL:) l C-C <br /> Type of Activity: <br /> ❑ Trenches 1:S1 Mound E 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 /> Lei(lei. CC )1ra ce v '/�' '//b <br /> /e):00.01Pap!1 <br /> yp lu-a.Ltct -Llc4, KPe.1 \-5,0 e ,0ry ,t44,K , vs <br />