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PERMIT
<br /> WOF ORONO PERMIT TYPE:
<br /> 2750 Kelley Parkway • P.O. Box 815 Permit Number: WATER
<br /> Orono, Minnesota 55356-0815 005b
<br /> (612) 473-7357 Date Issued: 1 1/01/93
<br /> SITE ADDRESS:
<br /> ORCHARD PK RD
<br /> cH
<br /> P . 1 . N. : 31-118-23-11-0003
<br /> DESCRIPTION:
<br /> SEPTIC SYSTEM _ ,....
<br /> spwer .t . _ _ _,... Type
<br /> c• Waf-Pr Permit T2.7F---,e NEW
<br /> RESIDENCE
<br /> ..7.,EPT IC SYSTE
<br /> Sewer b Water W....1.,
<br /> CITY OF OkONO
<br /> '...•r"ANCE OFFICE
<br /> REMARKS:
<br /> 1313300000 Yr
<br /> A i rrki i AO.00
<br /> I I 3 in-7T .1.V
<br /> ,...,....vvv,...
<br /> ry,
<br /> 01
<br /> LL -jt;
<br /> FEE SUMMARY:
<br /> ....LL. , nr
<br /> CHEA.,CuskpicIpT_TLTILIANKilt.ih.:1,,....:.5:).
<br /> $100 . 00
<br /> Base Fee
<br /> s_ 0 4,::.',9,967,..1-1 ,..1-:,.7)01 RV14 4i..., 91 .6‘.2...
<br /> Surcharge
<br /> Total Fee $100. SO
<br /> OWNER: _
<br /> CONTRACTOR: . . T _....1
<br /> 54718151
<br /> - Applicant. -
<br /> ANDFRSON LAWRENCE
<br /> PETFRSON ELMER ... (...,..it...E._ , _
<br /> 745
<br /> 5921 r-fq-.11E- A) _ ..--',E
<br /> C i R ONO ORCHAROMNPK. F,...D.5366
<br /> , , 1
<br /> nEi ANO MN 55„,.,........
<br /> 759-0258
<br /> . -- --') A71-8151
<br /> (b1.4.. ,,
<br /> , -
<br /> ..7." REQUESTS PERMISSION TO mAKE :Tl °ViirkilMPAR14-CIVII4E, CITNYTS°F
<br /> I ' - UNDERSIGNED HERtay WORK T t,4.e,oR'CT COMPLIANCE REQUIREMENTS. i
<br /> , - THEi't /-__.'ott '1•0 00 ALL ' , -,.. cjiNci.„.copE",..REQUI .
<br /> SPECIFIED AN0,-fty"It , -TATE,' o ttit4NE,,OTik. ou
<br /> tiR060 ORDINAK . ,,---M0 ,,,,,
<br /> ISSUED BY SIGNATURE ...,67...e..„( .
<br /> APPLICANT/PERMITEE SIGNATURE
<br />
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