Laserfiche WebLink
, , <br /> ** ATTENTION APPLICANT ** <br /> Fill in all a ro riate blanks and check all a ro riate boxes. <br /> 1 will be installing the following: <br /> Tanks <br /> `r Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: � <br /> Size of Tanks: i Z�� i ��%e i ��� <br /> Treatment System <br /> Trenches s.f. <br /> � Mound �J.3�' s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> NOTE: The contractor is required to provide an As-Built of the system before the <br /> final inspection. <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correct. <br /> a <br /> Si nature of A licant ���� ���� �������z- Date: �S ��' � � <br /> 9 PP �='� - <br /> MPCA License No.: ��� '� �57/ <br /> Staff Review: � Accept ❑ Denied <br /> Reviewer: C N�YI �� Date: � / l� J� <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> W:\(Permits)\Septic Permit Application-Updated Surcharge 07-28-11.doc <br /> 2 � 2 <br />