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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 includi s:_ the City of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: x Precast Concrete Other t anufacturer <br /> Tank Capacities: 1) IZSo gal. 2) /2,5-0 gal 3) gal. <br /> B. Pump Station(if required) Q <br /> dtW`tl :, k✓ hoar.)Pum make & model Zmiler //37 (ach pump curye <br /> & <br /> literature); system design requires L/? gpm at J ep feet orad. <br /> High water alarm make & tnod� JI S E/acL iasi ri_. (3utside <br /> electrical work to be completed by installer ,-k electrician&di Ekrl,.lc <br /> other . Inside electrical work must be completed by <br /> electrician. <br /> N4661a tiarla-�cG•^ �� C. Treatment System: <br /> /ItTrenches: s.f. <br /> 4 re t� L;d�4C4.1106 - �Mound <br /> ! Depth of rock below pipe " Rock bed dimensions <br /> ,..0,. 4. /0 ir?"'; DropBoxes /Q x�O3 <br /> .��ltran���o (�,kc Sand bed dirensions �3 'x Sy '-At-45 Cu.. <br /> Also fie C Distribution Box Pressure Dist, P'pe Diam, l sf �� <br /> Seca^ °"� S <br /> lto' 4I'j Maniford Pipe Diam. �'/QS <br /> D. Final Cover/Topsoil to be: borrowed from s.te <br /> (show location on site plan) <br /> Xtrucked 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 cf 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 cog4c,t. <br /> „S o k+e. st E,tca).4.,9,1.vc , <br /> SignatureofApplicant: /�. , : (�, __ t1� Dater, 7 <br /> f �9 <br /> MPCA Certification No.: r)3 GC <br /> Staff Review: Approv. Denial <br /> Reviewer: ...'+,is �3 "�Zis.i late:/' <br /> is _ <br /> Reason for Denial: <br />