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� ._ : � . <br /> '�:�� �- _ µ . _ _ -.. _ _... ,. , _ <br /> ' / ) 1�'�l l�"'�^r$`�M�►�-'a�:�13 <br /> ��� �Y '� :� � : /�^\ <br /> .. .� ,. : �/ <br /> ,g.-"-..,. . _._�:� , �-:� , ,.�:., ___. . ......�. . _._. .,�..�,..� .;�. . . `:7•�t` rf�.Q� x� ^i .„` sfjk'°�i', �Rt�i„ '�C'r� • .. .rr.,+� .-g.�-�.. <br /> . . ...�.. �_ . ... � .___. . . .y. .,... . :� <br /> SBPTTC SYSTrM .PffitMIT APPI.IC�ITON - PAGB 2 . , � <br /> ..� _ - .�- a a� `� <br /> . _ ._ <br /> - Per.ait Type & Fees (csec.�s one) - - . _ <br /> _. ,-..: � : <br /> New Construction, Full System $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 /> . � � ,. . <br /> $0.50 State surcharge added to above permit_ fees �� "��` � �-': <br /> S�E FEE SCHEDIILE FOR NON-�ESIDENTIAL PERMIT FEES ^� <br />� DO NOT MAIL PH�'1' WITS THIS APPI,ICATIOA <br /> :�*t:#**�*#:�***#***#******::***�*****�*#*#*::#:*##:*#**#****:s*�**#****t*# <br /> AOT�: ApFlicant must initial all spaces. Fi11 in all a�progriate blanks, <br /> check aIl appropriate boxes. <br /> Initial <br /> 1. I have received a cogy of the system design including the <br /> . City of Orono Septic System Approval Cover Sheet. <br /> 2. I will be installing the fo lowing: <br /> A. Tanks: �Precast Concrete �Other Manufacturer� <br /> Tank Capacities: 1)��gal. 2) fa7S� gaI. 3) ,,��gal. <br /> r <br /> B. Pump Station (if required) 5� � P'� I7 + <br /> Pump make & model ( tach gump curve & <br /> literature) ; system design requires ggm at feet <br /> of head. High water alarm make & odel . <br /> Outside ele�trical work to be completed by _installer <br /> �electrician other . Inside electrical work <br /> st be campleted by electrician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound � <br /> Depth of rock below pipe " Rbck bed dimensions ,�0'x � ' <br /> Drop Boxes Sand bed dimensions �g'x_�� <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pige Diam. � �-^=' <br /> D. Final Cover/Topsoil to be: borrowed from site ' <br /> (show locatioa oa site plan) <br /> _ �...._ .._ o._ _ _ � trucked in <br /> •#:*:***:*#******�***�:�*****:****##:*#*** **:****#�**�***�*****�:*****�** <br /> `he undersigned hereby applies to the City of Orono for issuance of a <br /> eptic system installation permit, agrees to do alI work in strict <br /> ccordance with the "ordinances of the City and the requlations of the State <br /> = Minnesota, and certifies that all statements made on this application <br /> re comp lete,. true aad correct. � . <br /> . _ <br /> ignature of AFplicant: � �'�' Date: � r/ <br /> _. <br /> :.. ,_ - _ .__ . .. <br /> .. <br /> . <br /> ?CA Certification No. : �� � _ <br /> ; <br /> � <br /> _. + <br /> 1 <br /> /v��' �/G,�ar^- � �7 � ,�� — l/1 S L" gSt� � _ � 1 <br /> � � <br /> ,7� �� ��5�� �- 6�- �� f <br /> /�� `�"8'�`� <br />