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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> / v� 1. I have received a copy of the system desi�n including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> 2. I will be installin�the follo�vina: p � <br /> A. Tanks: �Precast Concrete Other Manufacturer f �`��s�-SYS � � <br /> Tank Capacities: 1) /3�� gal. 2) ' �o gal 3) I Sc�G jal <br /> B. Pu Station (if required) <br /> Pump & model (attach p curve �c <br /> literature); sy desijn requires gpm at feet of head. <br /> High water alarm m & model . Outside <br /> electrical work to be comp by ins r electrician other. <br /> C. Treatment System: <br /> ; '� , Trenches: s.f. l�Iaund <br /> Depth of rock be pipe " Rock be �mensions x <br /> Dr oxes Sand bed dim sions ' x ' <br /> istribution Box Pressure Dist. Pipe �am. " <br /> Manifold Pipe Diam. " <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 /> a�rees to do all �vork in strict accordance with ordinances of the City and the re�ulations of the State <br /> of 1Vlinnesota,and certifies that all statements made on this application are complete,true and correct. <br /> Signature ofApplicant <br /> ����� Date: `� � 2y � � � <br /> � � � ��t� S G�� e� <br /> iVIPCA�,icense No. <br /> ---�------------------------------------------------------------------------------------------------------------- <br /> St�af'�'�e��e�a�: �p��-ov�9 �en��� <br /> �'����a�s�-o>�o ������� i<��i�.: D�teo `�I� �D`�� <br /> ���so� 'i��� �ena��: <br />