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SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2 , � � <br /> Permit Type & Fees (check one) <br /> N Construction, Full System $75. 00 . . <br /> eplace 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 �ermit fees <br /> SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES <br /> DO NOT MAIL PAYMENT WITH THIS APPLICATION <br /> �*************************************************************************� <br /> NOTE: Ap�licant must initial all spaces. Fill in all appropriate blanks, <br /> eck all appro�riate boxes. <br /> I i <br /> 1. 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 follo 'ng: <br /> A. Tanks: �Precast Concrete Other Manufacturer � <br /> Tank Capacities: 1 ) ���-gal. 2 ) �gal. 3 ) ��v� gal. <br /> B. Pump Station (if require ) <br /> Pump make & model �d��J� ,J��� (attach pump curve & <br /> literature ) ; system design requires �3 �gpm at �� feet <br /> of head. High water alarm make & model � �-- — G7� , .. �, <br /> Outside electrical work to be completed by _ nstaller <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 �'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: bor owed from site <br /> (show location on site plan) <br /> trucked in <br /> **************�*******��*�*******�*********�*#***#************:***********� <br /> The undersigned hereby applies t the City of Orono for issuance of a <br /> septic system installation permi , agrees to do all work in strict <br /> accordance with the ordinanc of e City and the regulations of the State <br /> of Minnesota, and certifi t t al statements made on this application <br /> are comp lete, true and c re <br /> Signature of A�plican . Date: �d � �'�� - � � <br /> MPCA Certification No. : � <br />