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� � � <br /> 1 <br /> ; , C� I� ", � <br /> � � �1�.. 5,�.�1. ,� � ,�',� _ 1`�..� <br /> I will be installing the following: <br /> T s <br /> Precast Concrete 0 Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: �- <br /> Size of Tanks: /J� <br /> Treatment System <br /> Trenches s.f. <br /> Mound s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> NOTE: The contractor is required to provide an As-Built of the system before the <br /> final inspection. <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of Applicant __ _.._ Dats. _. ! � <br /> MPCA License No.: ���Ic� <br /> Staff Review: �,Accept ❑ Denied <br /> Reviewer: Date: 1� / � <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> 2 / 2 <br />