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._ -- <br /> _ ,...., .. <br /> _ _ , , � <br /> ._.� . - e�.-r�_.. _._._ ---'�-- ."_..� ._.��� . .-h ..�-... <br /> . _..._. � ._ .. ._ ._.. . ._ _ .,... .. .._, �-.. _ . . _, _.... <br /> SBPTIC SYS�'�i PERMIT APPLIC�TON - PAG� 2 <br /> Pe�i.t Type � Fe�s (czec..� oae) : _ - <br /> Ve�a Construc�ian, Full Syst� $75. 00. . . . . . . . . . . : . . . . . . . - <br /> �e�I.ac� Exis�ing Syste� (I or more new tanks & drainfield) $�0.00. . . <br /> ?a�tial Replace�ent (replac� just tanks or just drainiie?d) $30. 00. . . <br /> '�.50 State surcharge added to above Fer•nit fees � � �� = <br /> S�E FEE SCHEDIILE FOR NON-3ESIDENTIt�L PERMIT rEES <br /> DO NOT MAIL P�iYI�:NT WITH THIS gPPI�IC�TIOA <br /> ***ff**f****�f*#�f#***f*****�********ft��#*:*f�*****f****#t**f**�t*��*f*�* <br /> OT$: Aaplicant must initial alI s�aces. FiII in alI azpro�riate blanks, <br /> chec�s aII. approcriate boxes. <br /> �:iti.al <br /> : � � ,, <br /> ��� 1. I have received a copy of the syste� desicn including the <br /> . City of Orono Se�tic System A�nroval. Cover Sheet. <br /> ��I�r� 2. I will be installing the following: � ' ' <br /> A. Tanks: �1 Precast Concrete �Other Manufacturer ' :�-x-�'" <br /> Tank Canacities: I) ��11.:� aal. 2) ;�":> ga?. 3 ) i/ ,�:'�✓ 9a1. <br /> , <br /> B. Pump Station (if required) . <br /> Pum� make & model/�,/�.-/�<��t ����'-` '� (attacZ gumn C`1Z'Ve & <br /> literatsre) ; syste� ciesign requires - v gF� at ''! feet <br /> of head. High water al.arn make & model 'U-,� �J�� <br /> Outside ele�trical. work to be com�leted by �iastaller <br /> electrician other Inside electrical wor?c <br /> must be campleted by electrician. <br /> C. Treatment System: <br /> 5 Trenches: ��'%� s.f. Mound <br /> Depth of roc?c below pi�e I �__ " Roc?c bed dimensions _'x ' <br /> ,�- Drop Boxes Sand bed dimensions 'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifol.d Pige Diam. " <br /> D. Final Cover/Togsoil to be: � borrowed from site " <br /> _ (show Iocation on site plan) <br /> ._ _ ._ _ trucked in - <br /> :�::****:**�**#:::**f*f:**:*:t**::*��***:::�f:�*f:#*f�***#�:***�:*f***�* <br /> � undersigned hereby applies to the City of Orono for issuance of a <br /> tic system instal lation permit, agrees to do aI.I work in strict <br /> �rdance with the ordinances of the City and the regulatioas of the State <br /> �tinaesota, and certifies that all statements made on this application <br /> comp lete,. true and correct. - � <br /> _ _ � � 7 i. , � � ' / <br /> � �� � , , <br /> �-�' �� � '�, ��i*,��_ Date: ,, �' � <br /> :ature of AFplicant: ���a_ — - <br /> Certification No. : � ��' <br /> t /� ` - � <br /> _ { <br /> _. . i <br /> � <br /> i <br /> I <br /> � , <br />