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_ f., 'r <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> � 1. I have received a co of the s stem desi n includin the Ci of Orono Se tic <br /> rY y r = � r <br /> _ System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: �Precast Concrete Other Manufacturer �wj� <br /> Tank Capacities: 1)��� Z1 gal. 2) ((�C gal 3) �p� gal <br /> B. Pump Station(if required) <br /> Pump make&model �c�l� WG�d.��� (attach pump curve& <br /> literature); system design requires �o gpm at /�7 feet of head. <br /> High water alarm make&model �e�Cti,r,.-�, . Outside , <br /> electrical work to be completed by installer t/electrician other. <br /> C. Treatment System: <br /> Trenches: s.f. '�� Mound <br /> Depth of rock below pipe " Rock bed dimensions /U ' x 5�� ' <br /> Drop Boxes Sand bed dimensions 5 Z ' x 7? ' <br /> Distribution Box Pressure Dist. Pipe Diam. I ��2 " " <br /> Manifold Pipe Diam. z" " <br /> D. Final Cover/'Topsoil to be: borrowed from site <br /> i(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 permit, <br /> a?rees 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 statements made on this application are complete,true and correct. <br /> Signature of Applicant Date: l� —� �—�� <br /> MPCA License No. �o `f Q <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staff Review: r 1 � ' t <br /> v Dema <br /> r <br /> Reviewer: Date: /D �t b`- f�C� <br /> Reason for Denial: <br />