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CITY OF ORONO <br />ON -SITE SEWAGE DISPOSAL APPLICATION <br />it M AIL, <br />(applican ) (please print) <br />property located at <br />being ther,(owner/owner's agent) of the <br />(number, street) <br />do hereby apply for a permit to install an on -site sewage treatment <br />system to serve .the <br />(residence, apt., commercial bldg., etc.) <br />at said ocation. <br />NeM System <br />Existing System Repair or Alteration <br />Name and address of installer L i l L <br />r <br />The following materials must be submitted for approval with this application: <br />1. Plot plan in, luding primary and alternate drainfield areas or showing <br />location of evisting tanks and drainfield. <br />2. Site Lwaluation 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 />comwscement 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 C - 2 (.-?CsP <br />Permit # <br />Signed T <br />r iqu� <br />Septic. Syst nspector <br />Signed r <br />( licant) <br />T.P nq.� 1� <br />(applicant"s address 6 phone) <br />Date of application <br />