Laserfiche WebLink
� � <br /> �-� - <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 install' g the following: �J�,�;,�e <br /> A. Tanks: �recast Concrete _ Other Manufacturer �,�j;•% <br /> Tank Capacities: 1) �000 gal. 2) �OGbgal. 3) `�OQ gal. <br /> B. Pump Station (if required) � <br /> Pump make & model �� (attac pump curve & <br /> literature); system desig rn equires �_ gpm at feet of head. <br /> Iiig� water alarm make & rnod.�1 Jutside <br /> electrical work to be completed by installer electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatrnent System: <br /> Trenches: s.f. �� � Mound �X � <br /> Depth of rock below pipe Rock bed dunensions� � <br /> Drop Boxes Sand bed dimensions 'x .�" ' <br /> Distribution Box Pressure Dist. Pipe Diam. 'Z " <br /> Maniford Pipe Diam. _�" <br /> D. Final Cover/Topsoil to be: bonowed 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 M' sota a certifies that all statements made on this application <br /> are complete, true and corr ct. ` ���� ,�, ���,�y����• <br /> SignatureofApplicant: Date: S �/J <br /> MPCA Certification No.: ���eg � �S i�0 <br /> -C � � / <br /> .�,�, : �s `Y� 4� �� �c��.� <br /> 1�1��.n�.iv n.-�`G�c�C <br /> Staff Review: App val � Denial �j y� �r�v�`��� . <br /> . � <br /> Reviewer: Date• '� —� <br /> T-- <br /> Reasc�n for Denial- <br />