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� s <br /> � <br /> t <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> bo <br /> L I have received a copy of the system design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> �� �� 2. I will be installin llowing: <br /> � ��� Manufacturer Ayw�h <br /> A. Tanks: Precast Concrete Other � <br /> Tank Capacities: 1) '/�v gal. 2) �gal. 3) � gal. <br /> B. Pump Station (if required) <br /> �l Pump make & model �.r �vs `� �o �r_� (attach pump curve & <br /> S� literature); system design requires � gpm at zo feet of head. <br /> u High water alarm make & model h k�,. S�-�H-���� . Outside <br /> ���5��n`� electrical work to be completed by installer electrician <br /> �u�p other . Inside electrical work must be completed by <br /> � electrician. <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions/U 'x ,�� <br /> Drop Boxes Sand bed dimensions��'x�' <br /> Distribution Box Pressure Dist. Pipe Diam. �%z ° <br /> Maniford Pipe Diam. Z " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> / (show location on site plan) <br /> ✓ trucked in <br /> The undersigned hereby applies to the Ciry of Orono for issuance of a septic system installation <br /> permit, agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this application <br /> are complete, true and correct. <br /> SignatureofApplicant: Date: � ���{�0 <br /> MPCA Certification No.: �p�(� <br /> Staff Review: Ap val Denial <br /> Reviewer: <br /> � �� Date: �-y c�O <br /> Reason for Denial• <br />