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.r <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 Ciry of Orono <br /> Septic System Approval Cover Sheet. <br /> �_ 2. I will be installing following: , <br /> A. Tanks: recast Concrete Other Manufacturer���C,j S <br /> Tank Capacities: 1) 2� Su gal. 2) 2f S�, gal. 3) tiso gal. <br /> B. Pump Station (if required) <br /> Pump make & model �Pc� S _��4°S (attach pump curve & <br /> literature); system design requires � gpm at � feet of head. <br /> High water alarm make & model �q,�,��o,_ ���,rT��. 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�� ' <br /> Drop Boxes Sand bed dimensions �'x�' <br /> Distribution Box Pressure Dist. Pipe Diam. /��" <br /> Maniford Pipe Diam. �- " <br /> D. Final Cover/Topsoil to be: �owed 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 /> SignatureofApplicant: _l��� � Date: CQ��.a/17 <br /> MPCA Certification No.: `� �� <br /> Staff Review: Approval �C Denial <br /> Reviewer: Date• �-(8-5l <br /> Reason for Denial: <br />