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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> � l. I have received a copy of the system desijn includin� the City of Orono Septic <br /> System Approval Cover Sheet. <br /> °�� 2. JI will be installin?the following: ��� <br /> A. Tanks: �cast Concrete Other Manufacturer�'l�y�'' � h <br /> Tank Capacities: 1)�al. 2) �i ov gal 3) ot� gal <br /> B. Pump Station (if required� <br /> Pump make&model `�j,a�l�� �N���_(attach pump curve 8i <br /> literature); system design requires 3�i apm at Z�7 feet of head. <br /> Hi�h water alarm make& model [,P,,..r/�.��,. . Outside <br /> electrical work to be completed by installer e ectrician other. <br /> C. Treatment System: <br /> Tre e : s.f. �.Nlound <br /> Depth; ck below pipe " Rock bed dimensionsll� ' x 6g ' <br /> 1' op Boxes Sand bed dimensions��('�' x fQtL'��� � <br /> Di �ibution Box Pressure Dist. Pipe Diam. I ��Z " <br /> Manifold Pipe Diam. 7� " <br /> D. Final Cover/Topsoil to be: borro�ved from site <br /> �show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system installation permit, <br /> ajrees to do all work in strict accordance with ordinances of the Gity and the rejulations of the State <br /> of Ivlinnesota,and certifies that all stateme s made on this application are complete,true and correct. <br /> Si�nature of Applicant �5 Date: /�' Z? - �� <br /> MPCA License No. �O �� <br /> ---�---------------------------------------------------------------------------------------------------------------------- <br /> Staf�"l�evie�`: Approva9 I)enial <br /> ��i�HeW�Z': `�1v��6` "��(5� I�ilt�': ���,� /'��l <br /> Reasor► �'oc� �eni��: <br />