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.� _ --;11-1-'.-1 <br /> +,ac '.rewe.�,t.. -?.r•'� "C�r...�.` �C..�...i rsws.�rw.c _ m - r. .-. -`- -� <br /> �:+.4^iwrt .�= '�` 3 sr�r }-�"krLt� s s- rY »",�sraw�lr+•7►C f rt1 *r •ro-r <br /> SEPTIC SYSTEM PERMIT. APPLICATON - PAGE 2 -.._.- -�-- <br /> Permit Type & Fees (check one) <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 /> $0.50 State surcharge: added to above permit fees - - _ <br /> SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES <br /> P I DO NOT MAIL PAYMENT WITH THIS APPLICATION <br /> *************************************************************************** <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, <br /> check all appropriate boxes. <br /> Initial <br /> al <br /> v 1. I have received a copy of the system design including the <br /> / . City of Orono Septic System Approval Cover Sheet. <br /> l 2. I will b installing the following: <br /> A. Tanks: recast Concrete Other Manufacturer <br /> Tank Capacities: 1) /00 (9 gal. 2) /COO gal. 3) /000 gal. <br /> B. Pump Station (if required) <br /> Pump make & model 7e4a3v %ar►va, (attach pump curve & <br /> literature) ; system design requires /,/Q gpm at 2-e feet <br /> of head. High water alarm make & model G__c_i/41a-Aa,--,r p L(,/ <br /> Outside electrical work to be completed by _installer <br /> electrician other . Inside electrical work <br /> must be completed by electrician. <br /> C. Treatment System: <br /> (/ Trenches: 7 j 0 s.f. Mound <br /> Depth of rock below pipe 1.2. ' Rock bed dimensions _'x <br /> Drop Boxes Sand bed dimensions 'x <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pipe Diem. " <br /> D. Final Cover/Topsoil to be: borrowed from site • <br /> (show location on site plan) <br /> _ . 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 all work in strict <br /> zcordance with the ordinances of the City and the regulations of the State <br /> f Minnesota, and certifies that all statements made . on this application <br /> :e complete, true and c-rrect. <br /> .gnature of Applicant: .�/.`/ Date: /0 <br /> 'CA Certification No. : <br />