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...-- ^ <br /> , * <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check aIl appropriate <br /> s. �� 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 installin followin�: � <br /> A. Tanks: Precast Concrete Other Manufacturer �r`�'�� <br /> Tank Capacities: 1) ac' oal. 2)1�a1 3)��--gal <br /> B. Pump Station(if required) <br /> Pump make&model 2-o e��-'� (attach pump curve& <br /> literature); system design requires �C) gpm at Z l feet of head. <br /> High water alarm make &model S •3� � CZ I�,,,,��s . Outside <br /> electrical work to be completed by installer �electrician other. <br /> C. Tr atme ystem: . / <br /> renches: s.f. �/ Mound Z — <br /> De of rock below pipe " Rock bed dimensions L_' x 3 Z' <br /> Drop Boxes Sand bed dimensions�U ' x��' <br /> ' Distribution Box Pressure Dist. Pipe Diam. /��Z " <br /> Manifold Pipe Diam. Z " <br /> D. Final Cover/Topsoil to be: �borrowed from slte�p'�/ <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 permit, <br /> ajrees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Nlinnesota,and certifies that all ments e on this application are complete,true and correct. <br /> SignatureofApplicant � Date: l� ��� —�� <br /> MPCA License No._�Q T V <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> �Staff Review: Approval Deniai <br /> . ��---�,�- / - `-�-�r.� <br /> Reviewer: D�te: <br /> Reason for I9enial: <br />