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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate� � <br /> boxes. <br /> � 1. I have received a copy of the system design including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> � 2. I will be installi followin : <br /> �� g . <br /> A. Tanks: ��Precast Concrete Other Manufacturer�Rrwi�✓ <br /> Tank Capacities: 1)1c��� gal. 2)/�ZJ gal 3) /�-t�0 gal <br /> B. Pump Station (if required) <br /> Pump make& model(��,(� ,/'���� (attach pump curve& <br /> literature); system design requires ��� gpm at Z 3 feet of head. <br /> High water alarm make& model ��,..e.(.c,ti�.-� . Outside <br /> electrical work to be completed by installer electrician other. <br /> C. Treatment System: <br /> Trenches: s.f. �ound <br /> Depth of rock below pipe " Rock bed dimensions 1� ' x S�S' <br /> Drop Boxes Sand bed dimensions �y�_' x � 3 ' <br /> Distribution Box Pressure Dist. Pipe Diam. / �'L " <br /> Manifold Pipe Diam. Z " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> �aw 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 /> agrees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Minnesota,and certifies that all sta ents m e on this application are complete,true and correct. <br /> Signature ofApplicant ----- Date: ��'"r�^� 3 <br /> MPCA License No. � ( � <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staff Review: Approval `� Denial <br /> Reviewer: �" + ' "'�;� �r�--c Date: �`���- �� � <br /> Reason for Den�al: <br />