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--_i 4 •�:+_.1 <br />•s-.Cw� _ .. _ _�....JLtt. +. :.. _�_•.� - _.w'��'•.�wi.•.r •ram` ..'�-feTNH�:[ <br />SEPTIC SYSTrM'PSRMIT APPLICATON - PA'Z 2 <br />•r.i v ..+f. .. �..... <br />Permit Type & Fees (check one) - :- <br />New Construction, Full System $75.00. <br />Replace Existing System (1 or more new tanks & drainfield) $50.00. . <br />Partial Replacement (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 />•I W NOT MAIL PAMIENT WITH THIS APPLICATION <br />HOTS: Applicant must initial all spaces. Fill in all appropriate blanks, <br />check all an-:opriate boxes. <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 follSWing: <br />A. Tanks: _Precast Concrete 1�LOther Manufacturer <br />Tank Capacities: 1) gal. 2) gal. 3) ��?=�� gal. <br />B. Pump Station (if re fired) <br />Pump make Q model /� c '�_>�_ (attach puma curve & <br />literature); system design recuizes ?,�,gpm at 14- feet <br />of head. High water alarm make & mode i�J- f rvr / <br />Outside electrical work to be completed by installer�� <br />electrician other I. side electrical work <br />must be completed by electrician. . <br />C. Treatment System: <br />Trenches: s.f. <br />Depth of rock below pipe %U " <br />Drop Boxes <br />Distribution Box <br />Mound <br />Rock bed dimensions Z Z'1' x <br />Sand bed dimensiohs " ,.- r ' <br />Pressure Dist. Pipe DLam.' " <br />Manifold. <br />Pipe Diam.' <br />D. Final Cover/Topsoil to be: borrowed from site <br />(show location on site plze.) <br />rucked in <br />lie II-AYYsig'IL. hereby applies to the City of Orono for issuance of a <br />apt.item installation permit, agrees to o all work in strict <br />oco,: :e with the ordinances of the City and the regulations of the State <br />and certifies that all statements made on this Zpplication <br />-r complete,. true and oorrec <br />:gnatnra of Applicant: J Date: <br />,CA Certification No.: <br />