Laserfiche WebLink
. r <br /> . • <br /> ** ATTENTION APPLICANT ** <br /> F'ill in all ap ro riate blanks and check ail appropriate boxes. <br /> I will be installing the following: <br /> Tanks <br /> ❑ Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: <br /> Size of Tanks: <br /> Treatment System <br /> Trenches s.f. <br /> Mound s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> Final Cover/ Top Soil <br /> to be borrowed from site (show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of Applicant Date: <br /> MPCA License No.: <br /> Staff Review: Accept ❑ Denied <br /> Reviewer: /� -��� 11.� �.� Date: � -�� - �� <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> _ ti5 tAilA t�v,�? �� �i��J .Qu . lc� ; �� 5 ��� .�' 1 l�N�. <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 2 � 2 <br />