Laserfiche WebLink
� . l�, <br /> :EPTIC SYSTEM PERMIT APPLICATON - PAGE 2 <br /> Perm:i.t 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 WITH THIS APPLICATION <br /> r**dr**t�rtt*�r*it*�**�r�t*t*****f*�t�tdr�r*t�*****t****ir*�r�t*�rtt*ir**�****�**�r�tdr��t� <br /> :dOTE: Applicant must initial all spaces. Fill in al.l appropriate bl.anks, <br /> check aIl appropriate boxes. <br /> Initial <br /> l. 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 Capac.ities : 1) /��� gal. 2 ) /� gal. 3 ) /boo gal. <br /> B. Pump Station (if required) <br /> Pump make & model ���ul w�0��� (attach pum curve & <br /> Iiterature); system design requires gpm at o2� feet <br /> of head. High water alarm make & model ,c.or��l �4�w� � <br /> Outside electrical work to be completed by _instal ler <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 " Rock bed dimensions �o 'x �`S�' <br /> Drop Boxes - Sand bed dimensions �'x 39 ',¢�e � <br /> Distribution Box Pressure Dist. Pipe Diam. /�y " <br /> Manifold Pipe Diam. Z'� " <br /> D. Final Cover/Topsoil to be: ,� borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> t�##�tf****�t*�******t#***t***�*#t��**�**f*#��:*:t***�#*#*t��***t*tt**�t*tt <br /> '�he undersigned hereby appl.ies 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 al 1 statements made on this application <br /> are comp 1 ete, true and correct. � <br /> � _._.._. . . <br /> Signature of Applicant: � Date. �^�� '� l3 <br /> :dPCA Certification No. : � / � ' <br />