Laserfiche WebLink
ATTENTION APPLICANT ** <br /> Fill in all appropriate blanks and check all.approprilate boxes. <br /> I will be installing the following: <br /> Tanks <br /> 1 Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list rnanutacwrer) <br /> Number of Tanks: 2 <br /> Size of Tanks: 1500/2 1000 GAL. LIFT <br /> Treatment System <br /> Trenches s.f. <br /> ,Mound s.f. <br /> Gravel less B.f. <br /> Chamber s.f. <br /> Final Covet 1 Top Soil <br /> t—t to be borrowed from site (show location on site plan) <br /> trucked in <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 ' �iDate: osil7rzooe <br /> MPCA License No.: 1-1595 <br /> Staff Review: ff-Accept <br /> �j ❑ Denied <br /> Reviewer: /,, .�,[,/� Date: (7- <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): c^ <br /> '5- tic AAJ FF cr eA�T <br /> 6)AA1 Ou--1 e-7- U 7.4A <br /> Reset Farm V:l(Permlts)lSeptic System Permk Applicafion.doc <br /> 212 <br /> £'d mg-Ltz (£9L) '63N119 310JdIN $ NV30 eO V:90 g0 86 deS <br />