Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
,, TIC SYSTEM PERMIT APPLICATON - PAGE 2 <br />Permit Type & Fees (check one) <br />clew Construction, Full System $75.00. . . . . . . <br />Replace Existing System (1 or more new tanks & drainfield) $50.00. . . <br />Partial Rerlacement (replace just tanks or just drainfield) $30.00. . . <br />$0.50 State surcharge added to above permit fees <br />SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES <br />DO AOT MAIL PAYP=T WITH THIS APPLICATION <br />AOTEs Applicant must initial all spaces. Fill in all appropriate blanks, <br />check all appropriate boxes. <br />Initial <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, -/,1,,,,,: ,,-fc <br />Tank Capacities: 1} iC gal. 2) iSCC% gal. 3)y;Q,ga1 <br />B. Pump Station (if required) <br />Pump make & model (attach pump curve & <br />literature); system design requires _,MffjWgpm at z 7 feet <br />of head. High water alarm make & modems . <br />Outside electrical work to be completed by nstaller <br />electrician other . Inside electrical work <br />must be completed by electrician. <br />C. Treatment System: <br />Trenches: s.f. <br />Depth Of rock b- eTow pipe " <br />Drop Boxes <br />Distribution Box <br />Mound <br />Rock bed dimensions 4�'x�' <br />Sand bed dimensions 2Y.. ' <br />Pressuia Dist. Pipe Diam.._" <br />Manifold Pipe Diam. _W.._ <br />D. Final Cover/Topsoil to be: borrowed from site <br />(show location on site plan) <br />trucked in <br />!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! <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 />MPCA Certification No.: <br />