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_ - -_ : <br /> NOTE: Applicant must irutial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> 1. I have received a copy of the system design includin� the City of Orono <br /> Septic System Approval Cover Sheet. <br /> ���� 2. I will be installin� the followina: <br /> A. Tanks: � Precast Concrete _ Other Manufacturer �-��cL�� <br /> Tank Capacities: 1) G'��O �al. 2) Uc'�' gal. 3) i ZSo gal. <br /> B. Pump Station (if required) �' s��� <br /> , - Q<�}� (attach pump curve & <br /> Pump make & model ���t.,� �.�� <br /> literature); system design requires �� gpm at Z� feet of head. <br /> C /-,� 11�,l:cir�A <br /> 't�i�11 Wdi.Cl dialiii illai:c :� ir'��u�� l��/{�•= ?`-^=" • <br /> electrical work to be completed by installer electrician�_ <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 5� ' <br /> Drop Boxes Sand bed d'unensions �'x�S ' <br /> Distribution Box Pressure Dist. Pipe Diam. �%Z " <br /> Maniford Pipe Diam. 2'" " <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 Ciry 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 /> �� , , Date: ��v `�� <br /> SignatureofArrlicant: �� �� ��--L =� � <br /> MPCA Certification No.: ��� �� �' l�����,--�-�� �`�' <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />