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City of O ono <br /> FOR CITY USE ONLY <br /> P.O.Box 6 B/ <br /> O i 5 21,,::O /�v Date Received: /U Permit#cid/D—OdlASS <br /> , , i 2750 Kelle Parkway gig,/ <br /> Crystal Bay MN 55323 <br /> Amount: 'de <br /> 1Nr. (952)249-4 00 r <br /> CITY'OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION RECEIVED <br /> (Al permits must be approved by the On-Site Septic Manager and/or Building Official) <br /> AUG _ 32010 <br /> CITyOFORON <br /> Site Address: 1350 Orono Oaks Drive Orono, MN. <br /> Ron & Karen Ridgeway 1350 Orono Oaks Drive <br /> Owner: 1 g y Mailing Address: <br /> Long Lake City: <br /> Zip: 55356 <br /> 738-2046 (612) 872-4272 <br /> Home Phone: (952) Alternate Phone: <br /> Contractor/App.: Buns Excavating, Inc. Contact Person: Steve Burns <br /> Address: 3470 County Road 21 State License#: 1888 <br /> City: Mayr Zip: Expiration Date: <br /> March 21 , 2011 <br /> (952) 955-3112 Phone: <br /> Alternate Phone: (612) 685-4303 <br /> "` „ rr et- .,. n 'siw .x.. ',;.,Z7,1414 Z} l' -.7: cn,. `,. .n, <br /> 0 Residential ❑ Commercial ❑ Other <br /> New or Replacemen System $200.00 200.00 <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> State Surcharge 5.00 5.00 <br /> Total $205.00 <br /> W:\(Permits)\Septic Permit Application-Updated Surcharge 7-1-10.doc <br /> 1 / 2 <br />