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•r, , 1 <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 installing the following: <br /> A. Tanks: �Precast Concrete _ Other Manufacturer <br /> Tank Capacities: 1)�� ga1• 2) ga1• 3) gal. <br /> B. Pump Station (if requir d � <br /> pump make & model � v c��9�• ��'�� (attach pump curve & <br /> literature); system design requires �/ gpm at 1.3 feet of head. <br /> High water alarm make & model �n �o T, . Outside <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�f� ' <br /> Drop Boxes Sand bed dimensions�_'x�'�{a <br /> Distribution Box Pressure Dist. Pi e Diam. I <br /> �� <br /> P <br /> Maniford Pipe Diam. 2�� " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> X 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 /> SignatureofApplicant: � Date: fa - � � ' � �� <br /> MPCA Certification No.: � � � 3. <br /> Staff Review: Appro al Deni <br /> Reviewer: Date: �� <br /> Reason for Deaial: <br />