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� � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> 1. 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 installing the following: <br /> A. Tanks:_� Precast Concrete Other Manufacturer <br /> Tank Capacities: 1)�D�D gal. 2)��s gal. 3) /��gal. <br /> B. Pump Station (if required) - <br /> Pump make & model ��,����f�- ��'-S/�G��ch pump curve & <br /> literature); system desig requires �� gpm at � feet of head. <br /> High water alarm make & model ��1����_ Outside <br /> electrical work to be completed by installer electrician� <br /> 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 'x ' <br /> s�Drop Boxes Sand bed dimensions 'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. �" <br /> Maniford Pipe Diam. " <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 City 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 /> �"�r�-7� ���'�� �'.iy <br /> SignatureofApplicant:� �r Date: �Y <br /> MPCA Certification No.: ���� <br /> Staff Review: Approval � Denial <br /> Reviewer: Date: /��7�� <br /> Reason for Denial• <br />