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�d9��/ <br /> - � c��l ti` '� 5/�o� <br /> �/06� <br /> /� � 10 SEPTIC SYSTEM PERNIIT APPLICATION <br /> (�,�n ���.� Iley ParkwaY) <br /> /�" l� � 5' S5323 <br /> �v ��- `3iC} ��e �/ <br /> tESS 390 Big Island <br /> � /� ��8_��3�� <br /> vccupancy Type: Residential ✓ Commercial Other _ <br /> Permit Type: New or Replacement System $100.00 100.00 <br /> Repair E�tisting System $ 50.00 <br /> (Tanks or Drainfield) <br /> $0.50 State surcharge added to above fees <br /> -7 * See fee schedule for non-residenNal permit fees <br /> 5�� � � <br /> � <br /> tc Owner's Name: Susan Bailey Phone Number: (612) 789-0545 <br /> Mailing Address: 2700 Hilldale Ave NE City: St. Anthorn Zip: 55418 <br /> Contractor's Name: � A►g� � ��;�nx. ' Phone Number: �.s a-�ys-���� '� <br /> Mailing Address: 1 .��3 t'? c� i,C� �T'f�Ck-' ,��'c.�i City: SkA i�'o;�t Zip: �� 3 7 � ��� <br /> Rd <br /> *** DO NOT MAIL PAYMENT WITH THIS APPLICATION*** <br /> GENERAL INSTRUCTIONS <br /> 1. Applications for septic system permits may be mailed or submitted in person at the City <br /> Offices; however, permits will not be mailed out. The permit must be picked up in person <br /> at the City Offices and work must not begin unless the permit card is on the job site. <br /> 2. Permits will be issued only to contractors holding a Minnesota Pollution Control <br /> Agency(MPCA)Septic System Installers License. <br /> 3. All work must be done irr accordance with the approved septic system design. Design reports <br /> are not considered approved unless accompanied by the "City of Orono Septic System <br /> Approval"cover sheet signed by the City Inspector. <br /> 4. The following inspections will be required for all septic systems: <br /> A. Pre-installation site inspection to include inspector, installer, and general contractor. <br /> B. Tank installation prior to covering. <br /> C. Drainfield trench installation prior to covering. For mounds, inspection is required after <br /> rough up but prior to sand placement(sand will be jar tested for silt content), and again <br /> during pressure distribution piping installation in the rock bed. <br /> D. Final inspection to verify proper final cover depths and to verify that all pump stations <br /> (where required)components are functional and comply with codes. <br /> 5. Individual holding MPCA Installers License shall be present during all inspections. A 24-hour <br /> notice is required for all inspections. <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br />