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<br />.,;/ <br /> <br />City of Ramsey <br />'1'13 NOWTHEN IOULEVARO N.W. RAMSEY, MINNEIOTA 11303 <br />'HONE '1121 "27.''''0 <br /> <br />, . <br /> <br />APPLICATION FOR SEWAGE DISPOSAL SYSTEMS <br /> <br />N~ <br /> <br />860 <br /> <br />the ordinanc:es <br /> <br />Applic:ation il hereby made for permit to do work lilted below in ac:c:ord with <br />of the City of lamley. <br /> <br />Loc:ation of job JM~p'S(()/1 &; AI".eI~ ~,e.~ <br /> <br />Owner #-ZAMS' -/ ,lid ~c: ~ Address Dt:1y ~ rd A,~~ <br /> <br />Lic:ensed Installer <br /> <br />New Work ( a.r <br />Replac:ement ( ) <br />Addition () <br /> <br />Permit Validation <br /> <br />Chec:k <br /> <br />Money Order <br /> <br />Cash (Circ:le One) <br /> <br />r <br /> <br />(Show loc:ation of house, tank, 'drainfield, property line and well.) <br /> <br />Tank Size <br />Square footage of <br />drainfield area <br />Depth of roc:k <br />under pipe <br />Dejith of roc:k <br />over i e <br />Depth of dirt <br />cover <br />Number of <br />bedrooms <br /> <br />,u,"'6 <br /> <br />,~-o <br /> <br />,f <br />,"" <br />,.." <br /> <br />. I <br /> <br /> <br />ble <br />Sewer pipe <br /> <br />House to tan Cast <br /> <br />Outside lift () <br />Ejector ( ) <br />Gravity ( ) <br /> <br />Permit fee -0 <br /> <br />Surtax <br /> <br /> <br />Note: <br /> <br />On ALL replacements and additions, .tanks must be.exposed <br />for baffle inspection. <br /> <br />Total <br /> <br />5cJ <br /> <br />l <br />L <br />" <br /> <br /> <br />By <br /> <br />Signature <br /> <br />P.hone: <br /> <br />Signature <br /> <br />lnstaller <br /> <br />~/ <br /> <br />Date <br /> <br />-81- <br /> <br />. ,.' <br /> <br />~ <br /> <br />t <br /> <br />NORTH <br /> <br /> <br />.- <br />