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CITY of ORONO <br />Cl wl Bv. M� ssm <br />BUDDING • ZONING - 473-7357 <br />ASSESSING <br />SEPTIC SYSTEM INSTALLERS <br />LICENSE APPLICATION <br />CCT261,%�B . <br />All questions must be answered. License fee, bona, certiricace <br />of insurance, and evidence of MPCA Certification or Home Sewage <br />Treatment Workshop attendance must accompany this application. <br />All applications are subject to a ten (10) day approval period. <br />1. Business or trade name Machtemes Construction <br />2. Business address P.O. Box 275, Waconia, Mn. 55387 <br />3. Business phone 442-4117 Residence phone same <br />4. Name of applicant or company representative holding MPCA <br />certification Charles J. Machtemes <br />5. Type of certification held: X Installer _ Pumper <br />Site evaluator System designer <br />Is tthis a Provisional Certificate? Y Certificate No. 1202 <br />F LOA -ft-_ b-3I /950 <br />6. If no Certificate is held, provide evidence of attendance at <br />one of the On -Site Sewage Treatment Workshops held immediate) <br />prior to the current construction season. <br />7. Have you ever held a Septic System Installer license in <br />Orono before? No Most recent year <br />S. Have you ever had a license revoked? YO When? <br />Where? _ <br />4. Do you do Municipal Sewer hook-ups? Yes X No <br />SUBMITTALS REQUIRED: <br />✓ 1. $25.00 license application fee. <br />2. $2000.00 license and permit bond naming City of Orono as <br />/ obligee. The State Plumbers Bond will nct be accepted. <br />J 3. $10-50-100,000 minimum Certificate of Insurance. <br />4. Copy of current MPCA Certificate or evidence of attendence <br />at On -Site Sewage Treatment Workshop held immedi tel <br />prior to current construction season.Vwfibp pJ�'M°Ck')'g5$ <br />LICENSES WILL NOT BE PROCESSED UNTIL ALL ITEMS ARE SUBMITTED. <br />List persons other than applicant who are authorized by you to <br />apply for permits under your license <br />The undersigned hereby makes application to the City of <br />Orono, Minnesota, for license to install and repair septic <br />systems, and/or pump out septic tanks, subject to the laws <br />of the State of Minnesota and the Ordinancgs of the City of <br />Orono. 7/ / i _ G�// <br />Date 10/25/1988 Applicants Signature 4�LG'i�'`+- <br />Staff recommendation Approval ,Z Denial Date-Z-Jr'rb <br />kk <br />CITY Reason for denial: <br />USE City Council Action Date Approved _ Denied <br />ONLY Date license mailed <br />