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Aug-21-2012 02:01pm From-CITY OF ORONO +9522494616 T-665 P-002/003 F-961 <br /> I will be installing the following: <br /> Tanks <br /> Al Precast Concrete [] Fiberglass ❑ Plastic Other <br /> (list manufacturer) <br /> Number of Tanks: 3 <br /> Size of Tanks: i z-:5'0 l z .-'o <br /> Treatment System <br /> Trenches S.f. <br /> _ Rc, Mound 103o S.f. <br /> Gravel less S.f. <br /> Chamber SS, <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 /> Signature of Applicant oleo Date: _ 2 I _/ Z <br /> MPCA License No.: L d 7 7 <br /> Staff Review: Accept ❑ Denied <br /> Reviewer: ��J Dater" <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> WA(Permits)\Septic Permit Application-Updated Surcharge 07-28-11.doc <br /> 212 <br />