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08,'1��;'2�Q? 1�: �� .�ia�3�G1k�2=E:1 hi!;i�R�CI<:.1��a PF�GE F_i11F�2 <br /> L . ,. , <br /> , ���.�OF ORO�1rO S�PT'IC S'!�5"l�EM PEI�MTT.AuPPi-f�CAT�Q� <br /> Boa�66(27,54�lley I'aa'kway) <br /> C�ps�al Bay,Mn 553Z3 � <br /> . , � � <br /> ,�o�a sr���nz��s��� � ����(�''� �r� � � _ <br /> Oceupancy 7Cype: Resider�teal �� _ C��xtpnercis! _ Other� <br /> Fermit Tppe: New or Replaeezr�ent�ystem �I()0.00 �Q�� P� <br /> Repair�xxsting Syst�rn 5 SO.DO __ _____ <br /> ('Tanlc� or Urainfie�d) <br /> �0.5� State surchar�e added to above fees <br /> � See f�e schedule f�r�o�-residential pernxit fees <br /> �� <br /> Ovvx�e�-'�Name: ; ��a r^� �-I�N� C.�2�K�rJ Pl�az�e Nuutber: 5 � '-� ��o ���C."� <br /> R�[ail'r��,1�.dei�ress:��K'S'__�'..�...; �ra f n% Cit'9� �/zOtVO Zip: �'� 3•��– <br /> Cr+ncractor's Name: L�2`�t����1�Cr''�' Phane Number:�.�l Z 2Z I__ l�f43 _. <br /> 1�Jf�ijir�g Address: ! U 5,� _____—City:�R�6� Zi�:_SS.��{1 <br /> !4�l,�CR l�rsc- 2�FL�`- , <br /> **« DO J'dl7'�'_�'I.4i�.�''A,�k"MENT'Gti'l,�'�'��ii9 AFPLICr�i.TION**" <br /> GEI�RA.L]ir+iST]E3..UCTIONS <br /> t. ,t�.pp.ti�a#ioss fqr septio systezz� permits rn�y he mail��l nr suhmitted in persan at the City <br /> Of�aaes; however, peruu,�.s vvill n�t be ax�ailerl aut. The permit must be picked up in perso� <br /> at th�C�k�-C�i�'ices and wor�C must not Y►e�in uz�less the�rermit cazd is o.n the job site. <br /> 2. �'srm'sts wil! t�p is::u�d or�ly to contr�ctorx holding a M.innesnta Pc�llution Cdz�tro� <br /> A.geacy(MYGAj Septie Sy�tam��s*�ll�rs Lic�ans�. <br /> 3. t�il.l w�7rk+uust Uc dc�no►n ac,ord�noc with thc approved septic system design, llesign seporks <br /> are nut cons�dered appr�ct°ed unless accainpasued by the "City o£ �rono Septic Syste�, <br /> A��ro��af'" r..�ver sheet signed by th�City Anspector. <br /> 4, Tbe fvlivwing in$pectxvns wiTl be required far al�s�gtic systerns: <br /> A Pre-insta3latian site in��+ection to incl.ude inspector,insta�l�z,arzd general contractor. <br /> B. Tank iastxllation pri�ar to�:overing. <br /> �. Dr3iilfl�.E�t�e�cfg installalaoia(�ri�r to�ovtrin�. For mouncis, x[�3per�ion is rcquir�cd a#�er <br /> raugh up h�t�rior to sand pfac�mp�t�sand will be jar tested for silt contentj,�nd agaan <br /> durin�t pr�s3ure d�strx6uainn pi�+in�3 inst�llation in tbe r�ck bed <br /> �t. Fin�1 iaspectian to verify pr�r�r fina� cov�r t�eptb�s azad to verify ihat all purnp statious <br /> (where re�ztired} cnaryponents are iunc:ion�al�nd caffiplg�v�rith cod�s. <br /> 5. Individualholdingl�LP�'A�nst�llersr.i�ens�sh�3lb�p�ese�tdi:riug�lli.nspections. A241�our <br /> nu�tice is rtequired for a!1 ir�spections. <br />