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, � <br /> CITy OF .ORONO SEPT'ICSYSTEI�IPEFtil�IITAPPLICAZTON <br /> Box 66 (2750 Kelley Pazkway) � <br /> Crystal Bay, I1� .I�I 55323 = <br /> � <br /> J'OB SITE ADDRESS: � �� SS� �T�.�-��� ���,� � ����-,'! �=,J' � � <br /> Occupanc�• Type: � Residential � Commercial Other � <br /> i <br /> Permit T�•pe: I�'e�v or � cement Svstem, �I00.00 ` <br /> Repair Existina System, � 50.OQ <br /> (Tanks or Drainfield) <br /> 0.50 State surcharge added to above fees � <br /> *See fee schedule for non-residential permit fees <br /> �"j � _ oneNumber:�'� - �,�/-�I L>u <br /> Ozvner's I�'a.me: � � ��, , � �`> ,,�u '� Tp: s� 3 �� <br /> N Address• �City: �` �%�� <br /> � , . � _ , __.�-�a, ; <br /> Iailina <br /> Contractor's I�rame: � l�a�ti� '���,��-� +ixN���ly Phonel\rumber:��l_��/�?/°G' <br /> I;'r� ;i � ��� rr��:. Y����� iL:+ S-S-�y v <br /> IYiailing Address:� � �'� ��, k Cit a�,.- ,, � �,�,Ytr �-P_______-- <br /> ��S�,yy <br /> DO \TOT tiIAII� PA'YI��LENT '4'YITH THIS APPLICATIOti' <br /> GE\rERA-L 1t�TSTRUCTIO`S <br /> 1. Applicacions for sep[ic system permits may be mailed or submitted in person at the Ciry <br /> Offices; however, permits will not be mailed out. The permit must be picked up in <br /> person at the Ciry Offices and work must noc be�in unless the permit card is on the job <br /> site. � <br /> 2, perm.its will be issued only to contrac[ors holdin� a City of Orono Septic System <br /> Inscallers License. <br /> 3, AlI work must be done in accordance with the approved septic system desi�n. Desi?n <br /> reQorts are not considered approved unless accompanied by the "City of Orono Septic <br /> Syscem Approval" cover sheet si�ned by the City Inspector. <br /> 4, The follow�in� inspections will be required for all septic systems: _ . <br /> � A, pre-inscallation site inspection to include inspector, installer, and general contractor. <br /> B. Tank installation prior to cover'in�. <br /> C. Drainfieid trench installation prior to coverin�. For mounds, inspection is required <br /> after rouQh-up but prior to sand placement (sand will be jar tested for silt con[ent), <br /> and a�ain durin� pressure dos er fin 1 cove de ths and to venfy tha al pump station <br /> D. Fuial inspection to venfy p p P <br /> (where required) componznts are funccional and comply with codes. <br /> 5, Individual holdin�MPCA Tnstaller Certificate shall be present durin� inspec[ions: A 2`�" <br /> hour notice is required for all inspections. <br />