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1989-11-08 Application for Septic System Permit
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1989-11-08 Application for Septic System Permit
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Last modified
9/11/2025 11:30:09 AM
Creation date
9/11/2025 11:26:19 AM
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Template:
x Address Old
House Number
710
Street Name
Dickey Lake
Street Type
Road
Address
710 Dickey Lake Road
PIN
3411823220016
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C I TY OF ORONO .f�- o15a -7 <br />ON -SITE SEWAGE DISPOSAL APPLICATION 4 75,5Z <br />I, 1 << being the (o,.rner/owner's agent) of the <br />(appli nt) (please print) <br />property located at _l/, V�- <br />(number, street) <br />do hereby apply for a permit to ilistall an on -site sewage treatment <br />system to serve the S,C�o <br />(residence, apt., comme.cial bldg., a c.) <br />at said location. <br />New System <br />Existing System Repair or Alteration <br />Name and address of installer6 _? J <br />The following materials must be submitted for approval with this application: <br />1. Plot plan including primary and alternate drainfield areas or showing <br />location of existing tanks and drainfield. <br />2. Site Evaluation Report. <br />3. Design plans and specifications. <br />In consideration of the granting of this permit, the undersigned agrees: <br />1. To furnish any additional pertinent information on the proposed work <br />that may be requested by the Septic System Inspector. <br />2. To abide by all provisions of the Ordinance of the City of Orono <br />and of all other pertinent ordinances or regulations that may be <br />adopted in the future. <br />3. To operate and maintain these sewage disposal facilities in a sanitary <br />manner at all times, in compliance with the requirements of the <br />City of Orono. <br />4. To notify the Septic System Inspector at least 24 hours prior to <br />commencement of the work proposed, and again at least 24 hours <br />prior to the covering of any underground portions of the installation. <br />Date approved Signed L r� <br />Permit # (app <br />dir�k) <br />Signed .C�;,�� <br />Septic System Inspector —)( pplicant's address & phone) <br />(y73- y.3I(e% <br />Date of application �' <br />
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