HomeMy WebLinkAbout1994-08-17 Permit, Septic System #006342.. •
PERMIT
CITY CF ORONO
PERMIT TYPE:
2750 Kelley Parkway - P.O. Box
815
Permit Number: ;EWER 14 WATER
Orono, Minne,-ota 55356-0815
006342
Date Issued:
(612) 473-7357
SITE ADDRESS:
1003 COX FARM
RD
P. I. N., 27-11 E-:-23-33-0014
DESCRIPTION:
DEPT I C Yr:TEM
';ewer
&
Water Permit- t'ype
NEW SEPTIC SY'STE
'.ewer
&
Water Wcirk Tyr r
RESIDENCE
REMARKS:
FEE SUMMARY:
Basi_ Fee ? , (-W), i�il
_surcharge _---__ --i--110
Tot -2.1 FEE � 100. L,()
CONTRACTOR: - App 1 i c ati t —
INGELS1DE ENGINEERING S4791E:69
4'-32-1C► HWY SS
RIjC:f;FiIRD MN SS373
LI TY OF GRONO
F 1 NA#q;E OFFICE
1.1344000 Y
01 GEN 144.40
41 WN 50
CHECK TL 100.50
RECEIPT-iMNr' YOU
# 311 wo 0441 R01 T14.39
OWNER:
W I LSC IN I-4-4
100:3 CIX FARM f,'D
CIRCINU MN bb' -466
47:?—/+799
THE UNDER' 1 GNED HEREBY F'ERM 1 E-,-; I i IN TO MAKE. THE REAL IMPROVEMENTS
°SPEC. I F I ED ANO AGREES TO i Dt i A! L V RK IN STRICT CI_1MF'L I ANCGt:. WITH ALL CITY O
'RONCI IFIRUINANI.:E-'_; AND :-;TATE CIE= MINNE.CA'ITA E:U)LDING C:' --IDE REQUIREMENT:-;.
L
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
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