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>EPTIC SYSTEM PERMIT APPI�ICATON — PAGP � <br /> • „ �'•' <br /> Permi.t Type & Fees (check one) <br /> New Construction, Full System $100. 00 . . . . . . . . . . . . . . <br /> _� Repair or Replace Existing System $50 . 00. . . . . . . . . . . . . <br /> �0. 50 State surcharge added to above permit fees <br /> SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES <br /> DO NOT MAIL PAYMENT WITH THIS APPLICATION <br /> r***f**:rt*�rtt**�*�t*f#*****t�rt��*�tt*#*��*#*it*t��r*�*t*ytir�r��t*�***t***ir:r��r�ftt <br /> :30TE: Applicant must initial. all spaces. Fill in aIl appropriate blanks, <br /> check all appropriate boxes. _ <br /> Initial <br /> � l. I have received a copy of the system design including the <br /> City of Orono Septic System Approval. Cover Sheet. <br /> �� � 2. I will be installing the following: <br /> A. Tanks: �Precast Concrete Other Manufacturer <br /> Tank Capacities : 1) ��gal.. 2 ) 1 7�a1. 3 ) gal. <br /> B. Pump Station (if required) <br /> P�np make & model (attach pump curve & <br /> literature) ; system design requires gpm at feet <br /> of head. High water alarm make & model � <br /> Outside e].ectrical work to be completed by _installer <br /> electrician other . Inside el.ectrical work <br /> must be completed by e�.ectrician. <br /> C. Treatment System: <br /> Trenches:� s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions �`x�' <br /> Drop Boxes - Sand bed dimensions �y'x� <br /> Distribution Box Pressure Dist. Pipe Diam. Z- " <br /> Manifold Pipe Diam. �_" <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> - (show location on site plan) <br /> trucked in <br /> #*����t�*�****��**�**f*#�***���#*�**�*#**t��*�**�t�***#***t�***�t*�**����f� <br /> mhe undersigned hereby applies to the City of Orono f or issuance af a <br /> septic system installation permit, agrees to do al 1 work in strict <br /> accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this app].ication <br /> are complete, true and correct. ' - <br /> � l � <br /> Signature of Applicant: ���0 ,_ _ � Date: ,�1� _ <br /> .�lPCA Certification No. : " <br />