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�. . � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> . �� . <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 installin the following: <br /> A. Tanks: �recast Concrete Other Manufacturer <br /> Tank Capacities: 1) orv gal. 2) � gal. 3) � gal. <br /> B. Pump Station (if required) � <br /> � '\1 pump make & model ��,v/r���!/����._ �attach pump curve & <br /> � literature); system design requires �_ gpm at � feet of head. <br /> High water alarm make & model �•�, �L.e�-o . Outside <br /> electrical work to be completed by installer �lectrician <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. /��i " <br /> Maniford Pipe Diam. 2 " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> w 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 /> S ignature of Applicant: <br /> Date: � ^ Z`� � S S� <br /> MPCA Certification No.: � 7 <br /> Staff Review: Appro � Denial <br /> Reviewer: Date: ����� <br /> Reason for Denial: <br />