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-� � <br /> NOTE: �Applican[ rriusc initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. . <br /> V� 1. I have received a copy of the system desi�n includi.na <br /> Septic System Approval Cover Sheet. : � �e Clry of Orono <br /> : � � � :2. I �vill be�installin; the followin�:�� - . <br /> A. Tanks: Precast Concrete Ocher Manufacturer <br /> �X;5�;,,q Tank Capacities: 1) 0 a o gal. 2)�gai, 3) �o gal;' <br /> I <br /> - B• Pump Station (if required) <br /> Pump make & model �a,�Jc� //� (attach pump curve & <br /> Iiterature); system design requires � gpm at �� feet of head. <br /> High �vater alarm make & model . Outside <br /> • ' electrical work to be completed by instalier_ electrician X <br /> ocher . Inside electrical work must be completed by <br /> electrician. � <br /> ' C. Treatment System: <br /> � Trenches: _ S,g, Mound <br /> Depch of rock below pipe �" Rock bed dimensions �'x � <br /> _� Drop Boxes � Sand bed di.mensions '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 uadersigned 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 ihe Ciry and the <br /> . regulations of the State of Mianesota, and certifies that aIl statements made on this application <br /> are complete, true and co <br /> SignacureofApplicant: �� . � . <br /> . Date.,� ,Z� 9 <br /> MPCA Certification No.:�L� . � - - � <br /> Staff Reriew: p oval Denial . . � <br /> . ,. <br /> � Revietver: ^ ' � � � <br /> � Date:_ ��} -o2S, �'q _ <br /> Reason for Denial: � <br />