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��c�"'m,-._:..�r' ----?^ :r. � - ... �,�> ;_ y.F $ _ - � _ . _ . .. .. <br /> ��' _ '��- _ ,� � �; s; `2` � <br /> _ .. _: _.� <br /> •�„ .:. . -- �- '' - - <br /> ..v_..ti�wa..�. •—.:+a-'^.�.w x+-- .,:r..�.c . r r y' . <br /> - .s.�+w:....� �;�Y.a..e �__-. �i+r�?�...n� - �a+'.re..�e _ >,;k.-; :' �-� :-.: ,> '�_..� `.: .... .� . .. <br /> � . <br /> �:_- , <br /> .�,.:-•.��+ee,r�rr=?' .".�._.._..,`"=:"_ . ,;� ._.-: .._ -::..-.:xe..�. --�_' . . .. .:�67t"k+rt��.. '.�+r� i ^,F '�4�:-►r'��!tr4�a �t r.--Mr a +F+er- - <br /> '.' . --'.� .-__:'. . _.,,. _ . .. ..�.,�.�a........:" '. ... <br /> ' SBPT=C SYSTSM .PffitMIT APPI.ICATON - PAG� 2 <br /> _ - Per.ait Type & Fe�s (csec.�c one) . .- - .- . - <br /> New Construction, Full Syste:a $75.00. . . . . . . . . . ;�:, . . ' . . �. � . - _. <br /> Replace Existing System (1 or more new tanks & drainfield) $50.00. . . <br /> Partial Replacement (replace just tanks or just drainfield) $30.00. . . <br /> $0.50 State surcharge: added to above permit; fees • . �- - -- : "'��'" -: . . <br /> SEE FEE SCHEDIILE FOR NON-TESIDENTIAL PERMIT FEES <br /> �' DO NOT MAIL PA3�'►' WITS THIS BPPI.IC�TIOA .- ' <br /> **�b*�t�t*�t�k:�t*�ts:ir#**ie#:*�t�t*�t�#:�t:***�t�t�kt*:�t�t*�k:**:**:#*�k!*�t:*ir**#**�*******t <br /> AOTS: ApFlicant must initial all spaces. Fill in alI azpropriate blanks, <br /> check aIl appropriate boxes. <br /> Initial <br /> 1. I have receined a cogy of the system design including the <br /> . City of Orono Septic Syste:a Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: �Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) ��"' gal. 2)��'aD gal. 3) ��al. <br /> B. Pump Station (if re ired) � <br /> Pump make & model �� ^ (attach gumn curve & <br /> literature) ; syste� design requires � � ggm at a &-- feet <br /> of head. High water alarm make & model L�. . <br /> Qutside electrical work to be completed by _installer <br /> ,�electrician other . Inside electrical work <br /> must be completed by electrician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound <br /> Depth of rock below pipe " R�ck bed dimensions ,�(Z'x� <br /> Drop Boxes Sand bed dimensions ��'x ? <br /> Distribution Box Pressure Dist. Pipe biam.�� " <br /> Manifold Pige D13IIi. �-� n <br /> D. Final Cover/Topsoi2 to be: barrowed from site ' <br /> ._ . <br /> _ (shew Iocation on site plan) <br /> •- - ,....___ . . ._ . . , trucked in _. <br /> *::****t::::**#***:�f:*�:*****::��****�**:: :::**:�**�f#***:**::***t:::*:t <br /> :�e undersigned hereby applies to the City of Orono for issnance of a <br /> �ptic system instal lation permit, agrees to do aIl work in strict <br /> �cordance with the'�ordinances of the City and the regnlations of the State <br /> = Minnesota, and certifies that all statements made , on this application <br /> _e comp l ete,. true and correct. ; - � . <br /> :gnature ef AFplicant f-�-L.� Date: � Il _. <br /> ::_. :. �. . -- --- . .._,...-. -- - <br /> . _ �-- - - _ _. . <br /> . ._ _ . . __ _ _ . . .- <br /> 'CA Certification Ne. : 2.��/ <br />