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SE2'Z'SC SYS -P�2MIT APPI,IC.3TON - PAGE 2 <br /> Pa�it Type & Fees (chec:, one) -- <br /> Ccnstr•":c=ion, Full System $75.00. . . . . . . . . . . . <br />?eclace Existing System (I or more new tanks & drainfield) $50. 00. . . <br />?a_-�-ial Replacement (replace just tanks or just drainfield) $30.00. . . <br />:0.50 State surcharge_ added to above permit. fees <br /> SEE FEE SC3EDULE FOR NON-RESIDENTIAL PERMIT FEES <br /> DO NOT MAST, PAM"MT WITH THIS APPLICATION <br /> #attfir�tir#ff*tsatfatatdrat#ff�ff*:f*�**:****:ffff**f*ff****f***fff**f*fit*f*f*fes:* <br /> 0T3: Applicant must initial all spaces. Fill in all appropriate blanks, <br /> check all appropriate boxes. <br /> :tial <br /> 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) L 2� gal. 3 ) � gal. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pumn curve & <br /> literature) ; system design requires qpm at 1T 7 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. Treatm t S tem: <br /> Tren h s: s.f. Mound <br /> Depth of ock below pipe Ack bed dimensions �'x <br /> D p xes Sand bed dimensions,.�Z'x 6-0 ' <br /> istrib ion Box Pressure Dist. Pipe Di m.1 " <br /> Manifold Pipe Diam. 1,�,� <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> �- -*t=ucked in <br /> undersigned hereby applies to the City of Orono for issuance of a <br /> :ic system installation permit, agrees to do all work in strict <br /> :rdance with the ordinances of the City and the regulations of the State <br /> Unnesota, and certifies that all statements made . on this application <br /> complete,. true and correct. <br /> ure of A Date: <br /> st pplicant: <br /> Certification No. : <br /> �7' I <br /> j <br /> I <br />