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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 installin e following: <br /> A. Tanks: Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) 0 � gal. 2) GOcJ gal. 3) ,� p p gal. <br /> B. Pump Station (if required) <br /> Pump make & model J1�f e va y�5 /��1= .5�7 (attach pump curve & <br /> literature); system design requires �3 gpm at ,�3.3 feet of head. <br /> High water alarm make & model �}�L' Outside <br /> electrical work to be completed by installer electrician 1/1 <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 /> Drop Boxes Sand bed d'unensions �'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 /> i <br /> SignatureofApplicant: � ...� Date: �1 �` <br /> -� <br /> MPCA Certification No.: ���r,�. �- <br /> Staff Review: Approval � Denial <br /> %' �'' �a�-9� <br /> Reviewer: Date: <br /> Reason for Denial: , <br />