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1 CITY ,OF RONO � b1�4730510 O6/12/97 10:59 � :03/03 N0:252 <br /> N '�`�: Appli�ant must initial all spaces. FiII in a!1 appropriatc blanks, check all apprapriate <br /> bo es. <br /> 1 . T have r�ceived a copy af the 5}'SL�fII design u�cluding the City of �rono <br /> Scpcic Systcm Apgroval Cover Sheet. <br /> 2, I will be ins�alling the followin�: <br /> A. Tanks: C� Precast Concrece � Uther Manufacturer � <br /> Tank Capaciti�s: 1� �� '�3I. 2) � g3�., �� �y aI. <br /> Cp',u�p� <br /> �. Purnp Scacion (if �Gqu(red) <br /> �'ump make 8c rnodel ���--�Qj'1C.��Y (artach pump curve & <br /> literattYre); system desi�r. requu�es �� gpm at __�_� feet of head_ <br /> High watec alacm make & model C7utside <br /> � � elect�ical work to be completed by instailer �C__ electrician <br /> acher . Inside electrical wark must be completed by <br /> electri�ian. <br /> C. Treatment Syst�m; <br /> Trenches; s.f. W�( hiound <br /> A�pth og rock below pipe ��_" kock bed dimensions �'x (�' x 1.05«� <br /> _ . Drop $oxes Sand bed dimensioru ��o���j� <br /> , Distribution �ox Pressura 17ist. Pipc I)iam. �� <br /> A-faniford PiQe Aiam. Z ` " <br /> 1�. �'inal Cover/Tapsoil to be: �_ borrowed f'rom site <br /> (show loCation on site plan} <br /> tn�cked in <br /> The ndersigned hereby applies to the City af Urono for issuance of a septic system inscallation <br /> pe it, a�rccs to do all work in strict accordance with ihe ardinances of the CiCy and the <br /> ragu tions of the Stat� of Minnesoca, and certi�es rhat all statements made on this appliGation <br /> ar� c mplet�. true and correct. <br /> Sign tuz'a�fApplicant; _ 1� -----------,—Aate:�13J97 <br /> 7V1P� CertiFication Na.:_1h�2 .,_�,... <br /> � <br /> Staff �ev�ew: Approv � Denial <br /> Revle ver: �-- Date: �_ �-�� - <br /> 1�easo for Denial: <br />