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v <br /> ' . <br /> SEPTIC SYSTSM P$RMIT APPLICATON - PAGE 2 <br /> Permit Type � Fees (check one) <br /> New Construction, Full System $100.00 . . . . . . . . . . . . . . <br /> � Repair or Replace Existing System $50.00. . . . . . . . . . . . . <br /> $0.50 State surcharge added to above permit fees <br /> SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES <br /> DO NOT MAIL PAYMENT WITS THIS APPLICATION <br /> �*�t****t**�*��*���*�**:�*******�*:****#*t*�*t*�*�**��*�*******#*�*#***t*#� <br /> NOT$: Applicant must initial all spaces. Fill in all appropriate blanks, <br /> check all appropriate boxes. <br /> I <br /> 1. I have received a copy of the system design including the <br /> City of Orono Septic System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: �Precast Concrete �Other Manufacturer <br /> Tank Capacities: 1) ���bL--gal. 2 ) 1/�'vv gal. 3 ) ��='L�gal. <br /> B. Pump Station (if re ire � <br /> Pump make & model � ,�' (attach pump curve & <br /> literature); system design requires gpm at �� feet <br /> of head. High water alarm make & model�j�c�r��.. ��:.���c�. <br /> Outside electrical work to be completed by insta� ler <br /> electrician other . Inside elec�t`rical work <br /> must be completed by electrician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound <br /> Depth of rock below pipe " Rock bed dimensions /D 'x <br /> Drop Boxes Sand bed dimensions �'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pipe Diam. �_" <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> ***********�:�t*********�********�*t:****���*�**:�:***��*�**�**�***�*�#��** <br /> The undersigned hereby applies to the City of Orono for issuance of a <br /> septic system installation permit, agrees to do all work in strict <br /> accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application <br /> are complete, true and correc , <br /> Signature of Applicant: Date: �"��` �� <br /> MPCA Certification No. : �•� � <br />