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PERMIT <br />MY OF ORONO PERMIT TYPE: <br />2750 Kelley Parkway - P.O. Box 66Permit Number. WA i FR <br />Crystal Bay, Minnesota 55323 <br />Date Issued: <br />(612) 473-7357 <br />SITE ADDRESS: <br />2700 C13UNTRY =;IDE OR W <br />CH <br />P - I . N. , 04-117-23-12-0012 <br />DESCRIPTION: <br />NEW SEPTIC: SY,=,TEM <br />Sewer t: Water Permit Type NEW SEPTI1= <br />Sewer h Water Work TYPE RES1DEN,,.E <br />REMARKS: <br />CII•v nr <br />— <br />FEE SUMMARY: 13133004th' tr z �1 <br />01 "I.;' 100.00 <br />Base Fee $100.00 01�` �' .50 <br />Surcharge ---------- t, -E i <br />Total Fee $100.SO <br />CONTRACTOR: - App t i c an t- i OWNER: <br />CL::IVE HILL COMPANY INC 57 :::7155 C. 1 HE hd TONY <br />6CsX 226 X700 COUNTRYSIDE Did W <br />SHAKOPEE MN S5379 ORONi � MN S62S6 <br />S6 <br />( G 12 ) 7'?:? -715.5 <br />TI iE UNDER ;1 GNED HEREPY RE0 ,(1E:'3T' ; PERM I':;S I i IN TO t1AKE THE REAL. I MF'R0VEMENTE; <br />SPECIFIED Anka AUtiEES TO 00 ALL WORK. IN STRICT COMPLIANCE WITH ALL CITY O <br />ORONO i i IRDINANCE' AND STATE OF M I NNE` -;i iTA E:1JI L.C) I N{ (A - DE Rt QU I REMFNT'-; . <br />A. -Vo 04e,�, <br />APPLICANTPERMITEE SIGNATURE ISSUEDBV: SIGNATURE <br />Jl <br />