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µ., <br /> ( s_ <br /> N .. ....r.�,�,g #?1 ,.... T»3;'>a. .. «k^'..$".✓,{ <br /> 4100 <br /> New or Replacement System $400.00 ` <br /> Repair Existing System T - 100.00 <br /> (Tanks or Drainfield) <br /> Total $ &-(0 <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and c rect. <br /> Signature of Applicanteee3( a 2 ZMPCA License No.: _L 4 <br /> Staff Review: ept Denied <br /> Reviewer: �� l/ Date: /(/'Z' 7/. <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> kzx x, } .. r'y5.,, -' C 4 I - tin f f -. ("1'�S` -c <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 at <br /> the City offices and work must not begin unless the permit card is on the job site. <br /> *** DO NOT MAIL PAYMENT WITH THIS APPLICATION *** <br /> 2. Permits will be only issued to contractors holding a Minnesota Pollution Control Agency <br /> (MPCA) Septic System Installers License. <br /> 3. All work must be done in accordance with the approved septic system design. <br /> 4. The following inspections will be required for all septic systems: <br /> A. Tank installation prior to covering. <br /> B. Drainfield trench installation prior to covering. For mounds, inspection is required after <br /> rough up, but prior to sand placement (sand must be jar tested for silt content) and <br /> again during pressure distribution piping installation in the rock bed. <br /> C. Final inspection to verify final cover depths and to verify that all pump station (where <br /> required) components are functional and comply with codes. <br /> 5. MPCA licensed Installers or their DRP (Designated Responsible Person) shall be present <br /> during all inspections. <br /> Page 2 <br />