Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
,EPTIC SYSTEM PERMIT APPLICATON - PAGE 2 <br /> Permit 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 PAYZZNT WITH THIS APPLICATION <br /> 40TE: Applicant must initial all spaces. Fill in all appropriate blanks, <br /> check all appropriate boxes. <br /> Initial <br /> 1. 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 ) /,�r?) gal. 3 ) )r2fD gal. <br /> B. Pump Station (if required) <br /> Pump make & model Jai, D (attach pump curve & <br /> literature) ; system design requires gpm at feet <br /> of head. High water alarm make & model <br /> Outside electrical work to be completed 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 pipe Rock bed dimensions <br /> Drop Boxes Sand bed dimensions <br /> Distribution Box Pressure Dist. Pipe Diam.L Y_� <br /> "ZIX If <br /> Manif old Pipe Diam. <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a <br /> septic system installation permit, agrees to do all 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 application <br /> are complete, true and correct. <br /> Signature of Applicant: Date: <br /> :SPCA Certification No. : <br />