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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriat <br /> boxes. <br /> 1. I have received a copy of the system design including the City of Oron <br /> Septic System Approval Cover Sheet. <br /> l .2. I will be installing the following: <br /> A. Tanks: I/ Precast Concrete Other Manufacturer LLJ t S <br /> Tank Capacities: 1) lodo gal. 2) /Dad gal. 3) 16SO gal <br /> B. Pump Station (if required) <br /> Pump make & model (;-, 1 n 5 —EAS - 3371 (attach pump curve <br /> literature); system design requires �_ gpm at 9 feet of head <br /> High water alarm make & model 4,,4�02 Outside <br /> • ' electrical work to be completed by installer electrician <br /> other Inside electrical work must be completed b <br /> electrician. <br /> C. Treatment System: / <br /> Trenches: s.f. 1/ Mound <br /> Depth of rock below pipe Rock bed dimensions /0 'x Z 7' <br /> Drop Boxes Sand bed dimensions 1-/0'xivr�,L' <br /> Distribution Box Pressure Dista Pipe Diam. <br /> Maniford Pipe Diam. Z c -"; <br /> D. Final Cover/Topsoil to be: borrowed from site <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 <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: Date: <br /> MPCA Certification No.: �s <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />