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- � . � . � ....- . ,. - -- -�+'—� -'- �—. .-..—•�y -t� . . . �,..,. . .. <br /> _ . — .c , _. �_ . _: �<.. . . ._ - _ _.,.,... <br /> S3PT2C SYST�i P�2MIT APPr,IC�TON - PAG� Z <br /> Pe_�it Type � Fe�s (cZe�:� oae) _ <br /> :�e�a Const�uc�ion, Full Sys�� $75. 00. . . . . . . . . . . . . . . . . <br /> ?eplac� Ex�s�ing System (I. or more new tanks & drainfield) $�0.00. . . <br /> �artial Re�Iac�ent (replac� just tanks or just drainiield) $30. 00. . . <br /> $0.5 0 State surcharge added to above p er•nit, f e�s � � � _ <br /> S�E FEE SCHEDQLE FOR NON-�SIDENTIAL PERMIT r�ES <br /> DO NOT MAIZ PAY�2+TT WITH THIS APPLIC�TIOA <br /> t**tf*****:rf***#***##�f#*******t*:***#f*:#**tt**�tf:***#f**tf�f****f�*ff*:* <br />��TOT$: An�Iicant must initial aII spaces. Fill in aII a�propriate blanks, <br /> che�k all appropriate boxes. <br />'nitial <br /> I. I have received a copy of the syste� design including the <br /> . City of Orono Septic Syste� A�proval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: �% Precast Concrete Other Manufacturer <br /> Tank Canacities: I) Gt��'� aal. 2) � � > gal. 3 ) gal. <br /> B. Pump Station (if required) <br /> Pumn make & model (attacz pumn curve & <br /> literat•sre) ; system design reauires gFin at feet <br /> of head. Hiah water alar� make & modeZ <br /> Outside elect��cal wor?c to be com�leted by _installer <br /> el.ectrician other Inside e.Iectrical work <br /> must be campleteri by ele�trician. <br /> C. Treatment System: <br /> � Trenches: ,�,> s.f. Mound <br /> Depth of rock below pipe �" Roc?� bed dimensians 'x ' <br /> _� Drop Boxes Sand bed dimensions 'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pi�e Diam. " <br /> D. Final Cover/TonsoiZ to be: borrowed from site ' <br /> (show location on site plan) <br /> _._ _ ._ . _ trucked in <br /> t*f*:***:**�::*****�f�*f***�*:*�*:�**tf:*:::�*�*:�:*f*******:�*�f:*****:� <br />�e undersigned hereby applies to the City of Orono for issuance of a <br /> _:tic system instal lation permit, agrees to do alI work in strict <br /> :��rdance with the ordinancas of the City and the regulations of the State <br /> Minnesota, and c�rtifies that alI statements made on this application <br /> = comp lete,. true and carrect. � <br /> n <br /> �ature of A�plicant: ��� � - ���.----- Date: � �`}���� . � <br /> _3 Certification No. : � 7 `� <br /> . i <br /> _. � <br /> � <br /> ( <br />