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2009-00577 - new septic
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3415 High Lane - 05-117-23-12-0017
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2009-00577 - new septic
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Entry Properties
Last modified
8/22/2023 5:16:10 PM
Creation date
1/26/2017 2:03:49 PM
Metadata
Fields
Template:
x Address Old
House Number
3415
Street Name
High
Street Type
Lane
Address
3415 High La
Document Type
Septic
PIN
0511723120017
Supplemental fields
ProcessedPID
Updated
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** ATTENTION APPLiCANT ** ' <br /> Fill in ali appropriate blanks and check all appro riate boxes. <br /> I will be installing the following: <br /> Tanks <br /> 0✓ Precast Concrete � Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: 3 <br /> Size of Tanks: �,000 �,000 �,000 <br /> Treatment System <br /> X Trenches s.f. <br /> Mound 34x54 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 nd correct. <br /> Signature of Applicant Date: 09�09/09 <br /> MPCA License No.: 1888 Reset Form <br /> Staff Review: Accept ❑ Denied <br /> `'� / /���J� Date: �`� j ����-y � <br /> Reviewer: � �' <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic Permit Application-New Permit Fees 2009.doc <br /> 2 � 2 <br />
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