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- . ��� <br /> . , � � ,�,� <br /> c���.�� <br /> CITY OF ORONO SEPTIC SYSTEM PERMIT�APPL�IC��N <br /> Box 66 (2750 Kelley Parkway) C/�, <br /> Crystal Bay,Mn 55323 �FORpNO <br /> , / • . , / <br /> JOB SITE ADDRESS __ iG�� T'P.t/f1 C�C� �� U�tC� l� � <br /> Occupancy Type: Residential�__ Commercial`__ Other_ _ <br /> Permit Type: New or Replacement System $100.00 <br /> Repair Existing System $ 50.00 <br /> (Tanks or Drainfield) <br /> $0.50 State surcharge added to above fees <br /> * See fee schedule for non-residential permit fees <br /> Owner's Name: /i��� J�j'���Sc;r� Phone Number: [Q/Z-3y`"/- p/G/ <br /> Mailing Address: ;�� f=c�,,i l,a.l� +�o,.d City: o�w.�� Zip: <br /> Contractor's Name:Xo-f'hr� k��xa', tti1�,_�e; �Ejc�u��i��ne Number: �.j- �F9�- b�v� <br /> Mailing Address: /���$`� (,c.��u�.-fz�� (�r r•�. (.`�ty: ;.s�C���/ Zip: �.i.j'�I <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 in 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 bcd. <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 />