HomeMy WebLinkAbout1978-06-26 Septic System Permit ApplicationCITY OF ORONO
ON -SITE SEWAGE DISPOSAL APPLICATION
it M AIL,
(applican ) (please print)
property located at
being ther,(owner/owner's agent) of the
(number, street)
do hereby apply for a permit to install an on -site sewage treatment
system to serve .the
(residence, apt., commercial bldg., etc.)
at said ocation.
NeM System
Existing System Repair or Alteration
Name and address of installer L i l L
r
The following materials must be submitted for approval with this application:
1. Plot plan in, luding primary and alternate drainfield areas or showing
location of evisting tanks and drainfield.
2. Site Lwaluation Report.
3. Design plans and specifications.
In consideration of the granting of this permit, the undersigned agrees:
1. To furnish any additional pertinent information on the proposed work
that may be requested by the Septic System Inspector.
2. To abide by all provisions of the Ordinance of the City of Orono
and of all other pertinent ordinances or regulations that may be
adopted in the future.
3. To operate and maintain these sewage disposal facilities in a sanitary
manner at all times, in compliance with the requirements of the
City of Orono.
4. To notify the Septic System Inspector at least 24 hours prior to
comwscement of the work proposed, and again at least 24 hours -
prior to the covering of any underground portions of the installation.
Date approved C - 2 (.-?CsP
Permit #
Signed T
r iqu�
Septic. Syst nspector
Signed r
( licant)
T.P nq.� 1�
(applicant"s address 6 phone)
Date of application