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<br />City of Ramsey <br />151&3 NOWTHEN BOULEVARD N.W. RAMSEY, MINNESOTA 15303 <br />'HONE 16121 427.1410 <br /> <br />APPLICATION FOR SEWAGE DISPOSAL SYSTEMS <br /> <br />J-: <br /> <br />or.- <br />e,t' <br /> <br />(Show location of house, tank,drainfield, property line and well.) <br /> <br />/'2.6.1' <br />of <br />6.50 <br /> <br /> <br />I <br /> <br />Tank She <br />Square footage <br />drainfield area <br />Depth of rock <br />under pipe <br />Depth of rock <br />over i e <br />Depth of dirt <br />cover <br />Number of <br />bedrooms <br /> <br />B~ <br /> <br /> able <br />Sewer pipe <br />House to tan Cast <br />Outside lift ( ) <br />Ejector ( ) <br />Gravity ( ) <br />Permit fee 50 (.v <br />Surtax 1$ ~C <br />Total 05'(1 .s'1 <br /> <br /> <br />- <br /> <br />t <br /> <br />NORTH <br /> <br />~{.;vJ <br /> <br /> <br />Note: On ALL replacements and additions, tanks must be exposed <br />for baffle inspection. <br /> <br />Signature phone: <br />Licensed Installer <br /> <br />Signature <br /> <br />Other than Licensed Installer <br /> <br />I <br />I <br /> <br />Date <br /> <br />By <br /> <br />-84- <br /> <br />Phone: <br /> <br />.' <br />....... <br /> <br />