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NOV.16.2006 1�46PM BOHN WELL DRILLIN6 N0.440 P.2i4 �� <br /> �/D,��'O <br /> 5� <br /> � //zD� �IOD <br /> , <br /> CITX OF ORONO SEPTIC SYSTEM PERNIIT APPLICATION <br /> Hux 66 (2950 Kelley Paxkway) <br /> Cry�tal$ay,Mio 55323 <br /> JO�SITE ADbRESS 22�a e�cy Gr���. i��G y�n <br /> Occupancy Type: Re�idential ✓ Commercial Other <br /> P@rmit Type: New or Reptacem@ut Sy�tem $100.00 I�D•�0 <br /> Repa�r�gi�ting sya�em � 50.00 <br /> (Tank�ox Drainfi�ld) <br /> 50.50 State aurcharge�dded to �bova fee� <br /> * See fee schedule for noa-re�ident�al perm➢t fee� <br /> Owner's Name: I aYVI u�YI GV1 Phone iVumber: <br /> MailingAddre��: 2��0 FveKa1� �r�►�y �(rG�� City: OVDino Zfp; <br /> Contractor'�Name: V► � ' I I h Phone Number; � a �45-�-SD�' <br /> Mail�ng�lddres�: � I Q_INIrV �, Sl�r,�ol � �City:� �fp; �y��y <br /> � - � <br /> *�'� DO NOT N�IL PAXMENT WITH TH�S APPLICATION*** <br /> STRUCTIONS <br /> 1. Applicataons for septic �yst�zr� per�raits may be ma.iled or eubmitted in person at the City <br /> Off ces; however, p�rmits will not be mailed out. The per�nit must be picked up in person <br /> at the City Offices and work must not begin unXeas the p�rmft card is on the job site. <br /> 2, Permits wi11 be issued only to contraetors holding a Minne�ota Pollution Control <br /> Agency(MPC,A) Septic Systiem Installers Licenae. <br /> 3, All work must be done in aecordanc�with the approved septic sy�tem design. Deaign r�porta <br /> ar� not eansidered appmv�d unless accoznpanied by the "City of Orono Sep�ic System <br /> Approval" cover�eet signed by the City Tnspector, <br /> 4, Tl�e following inspections will be r�quired for all septic �ystems; <br /> A, Pre-installation site inspec�ion to include inspector, ia�staller, a.nd g�neral conlractor. <br /> B. Tank in�tallatior�prior to covering, <br /> C. Drainfield tranch inatallatio�prior to covering. For mounds, inspcction ia xequir�d�.fter <br /> rough up but prior to sand placement(sand will be jar tested for silt cantent), and again <br /> dtuing pre�suro distributioa piping installation in the rock bed. <br /> D, Fina1 inspection to verify proper fmal oove�r depths and to verify that a1I pump �t�tiona <br /> (where required) eomponents are functional and comply�wi�th codes. � <br /> 5. �z�dividual holdi.ng MPC,A Installers Licenso sha11 be present during all ittsp�otions. A►Z�4-hour <br /> notEce is requfred for�il in�pecHon�. <br /> NOTE: Applicant must initial all ��acea, Fill in a11 appropriate blanks and cheel� all appropriate <br />