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SSPTIC SYSTEM P$RMIT APPLICATON - PAGE 2 <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 /> DO NOT MAIL PAYMLNT WITH THIS APPLICATION <br /> ***********#*************************************************************** <br /> NOTS: plicant must initial all spaces. Fill in all appropriate blanks, <br /> che all appropriate boxes. <br /> � <br /> In�it � <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 <br /> Tank Capacities: 1 ) � i % gal. 2 ) /%j�i�� gal. 3 ) /��"�J �'� gal. <br /> B. Pump Station (if re red) � �� ,��r/\�� <br /> Pump make & model /E� .; �- � � � (attach pu p curve & V <br /> literature) ; system esign requires 1� jgpm at ;��� feet �`' <br /> of head. High water alarm make & model/;�/�,, _,i- .��_�,�r <br /> Outside electrical work to be completed by _installer <br /> �electrician other Inside electrical work <br /> must be completed by electrician. • <br /> C. Treatment System: <br /> Trenches: s.f. � Mound <br /> Depth of rock below pipe " Rock bed dimensions�c?'x�' <br /> Drop Boxes Sand bed dimensions �'x�' <br /> Distribution Box Pressure Dist. Pipe Diam.�" <br /> Manifold Pipe Diam. � ' <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> ***************##********t#*�*******�**�***�**t*****#**�**#:�***��******� <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 app lication <br /> are comp lete,. true and correct. .� <br /> _ _ ' (- � � <br /> Signature of Applicant: �� Date: <br /> i <br /> MPCA Certification No. :�s<<� � <br />