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/333 <br /> ORONO COPY IL <br /> G"" 5'°� ORONO COPY 8- q-07 <br /> $-1 <br /> CITY OF ORONO SEPTIC SYSTEM PERMIT APPLICATION <br /> Box 66(2750 Kelley Parkway) <br /> Crystal Bay,Mn 55323 <br /> JOB SITE ADDRESS S 0 1,3 eis/.Q ti t> /�. ago., a <br /> Occupancy Type: Residential Commercial Other ' / -Y <br /> Permit Type: New or Replacement System $100.00 <br /> Repair Existing System $ 50.00 46'4- <br /> (Tanks or Dralnfleld) <br /> $0.50 State surcharge added to above fees <br /> *See fee schedule for non-residential permit fees <br /> /� nn cc/i <br /> Owner's Name: v9Rt lam_ c AST c Phone Number: ,-/p 7, Q - 5,1 <br /> Mailing Address: 8'M iQe13 4 .4//^7 e .S City.#*c. / <br /> Contractor's Name: .9.L. ?'G41QA.N j-v C_ Phone Number: 4/2 -/say <br /> Mailing Address: P0. LI y /v.20 City:)90444/ Zip: .S'$3y S <br /> QAC <br /> ***DO NOT MAIL PAYMENT WITH THIS APPLICATION*** <br /> GENERAL INSTRUCTIONS ORONO COPY <br /> 1. Applications for septic system permits may be mailed or submitted in person at the City <br /> Offices; however,permits will not be mailed out. The permit must be picked up in person <br /> at the City Offices and work must not begin unless the permit card is on the job site. <br /> 2. Permits will be issued only to contractors holding a Minnesota Pollution Control <br /> Agency(MPCA)Septic System Installers License. <br /> 3. All work must be done in accordance with the approved septic system design. Design reports <br /> are not considered approved unless accompanied by the "City of Orono Septic System <br /> Approval"cover sheet signed by the City Inspector. <br /> 4. The following inspections will be required for all septic systems: <br /> A. Pre-installation site inspection to include inspector,installer,and general contractor. <br /> 13. Tank installation prior to covering. <br /> C. Drainfield trench installation prior to covering. For mounds, inspection is required after <br /> rough up but prior to sand placement(sand will be jar tested for silt content),and again <br /> during pressure distribution piping installation in the rock bed. <br /> D. Final inspection to verify proper final cover depths and to verify that all pump stations <br /> (where required)components are functional and comply with codes. <br /> 5. Individual holding MPCA Installers License shall be present during all inspections. A 24-hour <br /> notice is required for all inspections. <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> CITY OP ORONO <br /> sEPTIC <br /> !NSP Air 40- <br /> MIS IS MOM DATE .: i1 • •MIT Mogiairo«e,..erw <br /> in APPROVED AS 11ORMITTED <br /> Of*SNOOK SIVASAILS ONES.__jr - 1401 APPROVED—CORRECT dr RESUEMrr <br /> $keee neasams+w ter taw ireformaileak Aid week Eel4-M <br /> *AA ssoptiosoe wilk ottapplicable'email sal Imlay coda <br /> *c meati isaladieg Roma act specifically assadialblaileV4 <br /> 40TIANi$A$MgiWIna aTA44 <br />