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I <br /> NOTE: Applicant musc initial all spaces. Fill in al1 appropriate blanks, check all appropriate <br /> boxes. . <br /> �/ 1. I have received a co of 'Q • ' <br /> py the system desi,n uicludin� the Ciry of Orono <br /> Septic System Approval Cover Sheet. � <br /> .2. I �vill be installin; the followin�: <br /> A. Tanks: _ precast Concrete Other Manufacturer �'-c.�,,C..l.� <br /> Tank Capacities: 1) DU gaI. 2) �al. 3) �al. <br /> � a , <br /> B• Pump Station (if required) ,��� <br /> Pump make & mvdel �'�<��� (attach pump curve & <br /> literature); system desi�n requires ,� , opm at /� feet of head. <br /> , Hi�h �vater alarm make & model _ ���,,� Outside <br /> � etectrical 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 �U'x�C ' <br /> Drop Boxes Sand bed dimensions y��'x �� ° <br /> Distribution Box Pressure Dist. Pipe Diam. �" <br /> Man.iford Pipe Diam. �'� " <br /> D. Final Cover/Topsoil to be: �borrowed from site <br /> �ow location on site pla�) � <br /> trucked in <br /> The undersi?ned hereby applies to the Ciry of Orono for issuance of a septic system installation <br /> permit, agrees to do all work in strict accordance wich the ordinances of the City and the <br /> reguIations of the State of Min.nesota, and cenifies that all s[atements made on this application <br /> are complete, true and co e . <br /> Si�natureofApplican[: — �� � � L .,C�� <br /> ��--_ Date:_J,�.— � , <br /> MPCA Certification No.:_ � ZC� - � <br /> Staff Review: Approv -� Denial <br /> . /� <br /> Reti-ietiver: , _.� ;' � Date: �� �'�� � � ' <br /> Reason for Denial: <br />