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i 4 <br /> CITY OF ORONO SEPTIC SYSTEM PERMIT APPLICATION <br /> Box 66(2750 Kelley Parkway) <br /> Crystal Bay,Mn 55323 <br /> JOB SITE ADDRESS <br /> ds 0 1 dys+ -ec( f 120S .W) <br /> Occupancy Type: Residential X Commercial Other <br /> Permit Type: New or Replacement System $100.00 (.5 '/ 00.DO <br /> Repair Existing System $ 50.00 <br /> ('ranks or Drainfield) <br /> $0.50 Stite surcharge added to above fees 100,e 0 <br /> * See fee schedule for non-residential permit fees <br /> Owner's Name: Nb l Phone Number: `�SZ' T% ` I lsc <br /> Mailing Address: �IO�/� Id Cry rz � r S• City: Ornn0 Zip: 5S3S7p <br /> Contractor's Name: ISO . ram-S'etwe r (i —v Phone N mber: "7co 3' 894710 a- <br /> Mailing Address: /40S-9 (,()h,',i LOt,,ti� City: 2✓Zip: $-S�3cLI <br /> *** DO NOT MAIL P4YMENT WITH THIS APPLICATION*** <br /> GENERAL INSTRUCTIONS <br /> 1. Applications for septic system permits may be mailed or submitted in person at the City <br /> Offices; however, permits will not be mailed out. The permit must be picked up in person <br /> at the City Offices and work must not begin unless the permit card is on the job site. <br /> 2. Permits will be issued only to contractors holding a Minnesota Pollution Control <br /> Agency(MPCA) Septic System Installers License. <br /> 3. All work must be done in accordance with the approved septic system design. Design reports <br /> are not considered approved unless accompanied by the "City of Orono Septic System <br /> Approval" cover sheet signed by the City Inspector. <br /> 4. The following inspections will be required for all septic systems: <br /> A. Pre-installation site inspection to include inspector, installer,and general contractor. <br /> B. Tank installation prior to covering. <br /> C. Drainfield trench installatioi prior to covering. For mounds, inspection is required after <br /> rough up but prior to sand lacement(sand will be jar tested for silt content), and again <br /> during pressure distribution piping installation in the rock bed. <br /> D. Final inspection to verify p oper final cover depths and to verify that all pump stations <br /> (where required)componen s are functional and comply with codes. <br /> 5. Individual holding 1M1PCAInstal ers License shall be present during all inspections. A 24-hour <br /> notice is required for all inspe tions. <br />