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� <br /> ��..:� -" �... ��.T. _ �t' � _ ��� <br /> ; ..� �„�,.. ���.-_..�_.._t - �c:...- 4 — _ - ' - _. , __ . .. _ . ' <br /> , �. � � <br /> _ . , __ <br /> � , <br /> ; � -. �._ . „-_.. -.-_ ._.....:. . -, . .. � �._-_�_ ' , ... . � :-..Ys. �;ss `s:rrg:�,�r �^f.�fra�'�r-�'►t'"'� _..R�a Wt�r.�rT� ..xyr.,. .- <br /> , <br /> >�.,::a r :..,_'� .�. .�' ' _ -. .._ :.,,.. . _. ._. . �• .� <br /> ' _.. � . _ .�.- . - .... " ,.l,.S�~•. <br /> SSPTIC SYSTrM .P�2MIT APPI.IC�TON - PAG� Z �--- -,f.�;y_#, ._Y �___ ..A ,,,R`µ�,_#_ � <br /> _ _ : �`. , _ <br /> .� �. ` + <br /> Per.nit Type � FeAs (c�ec.� one) _..__ . , � �- - <br /> New Construc�ion, Full System $75.00. . . . . . . . . ; � . . . . . . . - - <br /> Re�Iace Existing System (1 or more new tanks & drainfield) $�0. 00. . . <br /> Partial Replacement (replace just tanks or just drainfield) $30. 00. . . <br /> $0.50 State surcharge_ added to above permit, fe�s . . _ �v �" �� <br /> S�E FEE SCHEDULE FOR NON-�ESIDENTIAL PERMIT FEES <br /> �� DO NOT MAIZ PA�TT WITH THIS gPPI,IC�TION <br /> t***#�*�t**:********#******:****#*********#**#t***#t*#****3t***t**t*ftt�**# <br /> NOTS: Ap�Iicant must initial all spaces. Fil 1 in alI azpropriate blanks, <br /> check a11 appro�riate boxes. <br /> Initial <br /> � 1. I have received a copy of the system design including the <br /> . City of Orono Septic System A�nroval Cover Sheet. <br /> 2. I will installing the folZowing: <br /> A. Tanks: �Precast Concrete Other Manufacturer <br /> Tank Capacities: I) � ���� aal. 2) f � C'��� gal. 3 ) Gl � OC� gal. <br /> B. Pumn Station (if required) <br /> Pumn make & model �r,.L��,�y ��,,,✓,���; ��`�I , (attach pump curve & <br /> literat•sre) ; system des ' gn reauires ' 7 ggm at �-i� feet <br /> of head. High water alar.n make & model�_Lti_-/�/�,�y n j�L� <br /> O�tside electrical work to be completed by _installer <br /> �� electrician other Inside electrical work <br /> must be completea by electrician. . <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions L'x.�5�' <br /> Drop Boxes Sand bed dimensions �'x '� ' <br /> Distribution Box Pressure Dist. Pipe Diam. �%z. " <br /> Manifold Pi�e Diam. 2 " <br /> D. Final Cover/Topsoil to be: borrowed from site ' <br /> _ (show Iocation on site plan) <br /> ._ _ ._ � trucked in <br /> #:***#*�#*:*****f**:*****#*f**::t****#tt**:***:t**::#*****t*t:*****f*****t <br /> 7e undersigned hereby applies to the City of Orono for issuance of a <br /> �ptic system installation permit, agrees to do all work in strict <br /> �cordance with the ordinances of the City and the regulations of the State <br /> ' Minnesota, and certifies that a11 statements made on this app lication <br /> =e complete,. true and c rrect. . <br /> _ , . ._. _ . . ._ . � , <br /> -gnature, of AFplicant: ��'(,F-� '. . Date: /D -/�- �/ <br /> 'CA Certification No. : <br /> � � f <br /> �S� �`� � `.,, � �_23��� <br /> � <br />