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_ . <br /> .� .... _,,. . ,-- �. - _ _ _ _ _ <br /> �, ,,,,r��:�_�r. ��::: -. _ . � == � - - _ - — - _ . . .. <br /> -_.- '-, . - ' _ - . � `{-- — - � . <br /> . ._.,.._ , — .. _ ,_ . . .. . . . . . <br /> . . . . - .... .,. . . .- �. , _ ... . . . <br /> - :. ::. _. ._. . -.� -� -z,�.-;._._ .. .....�.� ..._.- . � k' - - - "'rq'^'�yf` �t.y�-n-�� �-+�C- ' <br /> . . '..r� 5• � ��+''r�:�.���..� f�i�S)d.'. +�hry:. <br /> -- _ �..:,-..aM.'v' - .�. .. - -...__ .__. . . _ , '....... . .. . �-' ' <br /> .. ..._._ _._"'_ _�...�' _ ��. �r-•_" ' _' "�:._ _.. ...._:�� <br /> S3PTSC SYST�..M .PERMIT APPLIC�TON - PAG� 2 <br /> _ ��� �.�. _ ... . .. <br /> Per.ait Type & Fe�s f c�e�.� oae) _�__ . � � �.'.� <br /> Neza Construc�ioi�'uIl Syste_n $75. 00. . . . . . . . . : • . . . . . . . - - <br /> Replace Existing System (1 or more new tanks & drainfield) $�0.00./-: '. <br /> Partial Re�lacement (repl.ace just tanks or just drainfield) $30. 00. . . <br /> $0.50 State surcharge added to above permit: fees . . _ -_ ...:r _. <br /> SEE FEE SCHEDIILE FOR NON-rTESIDENTIAL PERMIT FEES <br /> II DO NOT MAIZ PA�7T WITH THIS gPPI,2C�TION <br /> *f*:ff*��**�*****�*#*:***:*******t*t*#*t****:***t*#f******:**tft*******tt*# <br /> NOTSs Applicant must initial alI spaces. Fill in aIl a�progriate blanks, <br /> check aIl appropriate boxes. <br /> Ini� <br /> "% 1. I have received a cogy of the system design including the <br /> - ' . City of Orono Septic System A�nroval Cover Sheet. <br /> ;�, � . <br /> - 2. I will be installing the following: __ -- <br /> A. Tanks: �' Precast Concrete Other Manufacturer; � � � + <br /> -�-- <br /> Tank CaDacities: 1) � "' ' aal. 2) " � "� ` gal. 3 ) ' ' gal. <br /> B. Pumn Station (if re�zired) <br /> Pump make & model ;-;/ ' _ ;;% - i�� (attach gumn curve & <br /> literature) ; system design requires � ;� ggm at � " fe�t__, <br /> of head. High water alarm make & model ��-. ; :- � . <br /> Outside electrical work to be com�leted by _installer <br /> electrician other Inside electrical work <br /> must be completed by electrician. • <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below gipe " Rock bed dimensions �'x�!) ' <br /> Drop Boxes Sand bed dimensions.;= ) 'x�_' <br /> Distribution Box Pressure Dist. Pipe D�. ���� " <br /> Manifold Pi�e Diam. �" `� <br /> D. Final Cover/Topsoil to be: borrowed from site ' <br /> (show Iocation on site plan) <br /> _ _ _ _ trucked in - <br /> �**�:::*::f**�*#****�***t*****::***t:**t**:*:**t�:*****t*t**t**:*f�******f <br /> 7e undersigned hereby app Iies 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 al I statements made on this app lication <br /> =e comp lete,. true and correct� . <br /> / <br /> _ .. . � .. . " _ <br /> _ __. <br /> :gnature of AFplicant�%-���,��.��/�/�:�� _���� � Date: �i � � <br /> , .. �. - , <br /> _ . _. . _ - -- <br /> - �. <br /> 'CA Certification No. : �_ �='" <br /> �..:�� � �� ��T �r <br /> � ���5 � � � <br /> d �' � 1 <br /> 1 <br /> ��. sn� y�- ��.. , <br /> ��� � �,� � <br /> _ _ <br /> _ <br /> �__.,_______., .. ___ ___ __ _ _____._ . _ _ __ ._ .. . <br /> _ <br />