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PERMIT <br /> 2�1-TY OF ORONO PERMIT TYPE: <br /> 50 Kelley Parkway Box 815 Permit er: WATER <br /> Orono, Minnesota 55356-0815 Date Issued: <br /> q12) 4717357 11/24/9:--.: <br /> SITE ADDRESS: <br /> 621 NORTH STREAM RID <br /> jB <br /> P . I . N . ; 25-118-23-34-000-/, <br /> DESCRIPTION: <br /> Sewer A Water Permit Type NEW SEPTIC SYSTE <br /> Sewer & Water Work Type RESIDENCE <br /> CITY J-11F L010116%;'hill <br /> Fliki"I44"C'Er' j'FF.,Ti7E <br /> 1 131 J171 6010"ick) <br /> 6,1 IVLtT 100.016, <br /> 12222&06-00 <br /> #2916'90 LVV1 li'01 Tl'J:l <br /> REMARKS: <br /> FEE SUMMARY: <br /> Base Fee $100 . 00 <br /> Surcharge ----------1-5-0 <br /> Total Fee $100. 50 <br /> CqNTRACTOR: Applicant -- OWNER: <br /> QUICKWAY EXCAVATING 54775077 L CRAMEE CO <br /> BOX 50S 521 NORTH STREAM RD <br /> ROCKFORD MN 5537:3 ORONO MN 55391 <br /> (612) 477-S077 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT.':-:, <br /> SPECIFIED AND AGREES TO DF.i ALL vJ-DIRK 114 STRICT C13MPLIANCE WITH ALL CITY OF' <br /> 11*��t-l[�)j:,i---...i.17,.�.-*c.:E!--.; AND SIA" L OF MINNESOTA ENILDING CODE REQUIREMENTS . <br /> APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE <br />