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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> ✓ 1. I have received a copy of the system desiLyn including the City of rono <br /> Septic System Approval Cover Sheet. cvee- Q <br /> V 2. I will be installing the following: <br /> A. Tanks: s Precast Concrete _ Other Manufacturer <br /> Tank Capacities: 1) ogal. 2) � gal. 3) o gal. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system design requires gpm at feet of head. <br /> High water alarm make & model utside <br /> electrical work to be completed by installer electrician e2 <br /> other f 4t Inside electrical. work must be comple ed by # <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. V, Mound <br /> Depth of rock below pipe " Rock bed dimensions 10' 'x D ' <br /> Drop Boxes Sand bed dimensions TK'x p ' <br /> Distribution Box Pressure Dist. Pipe Diam. Ch <br /> z " <br /> Maniford Pipe Diam. <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 instai lation <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 appl' ation <br /> are complete, true and correct. <br /> SignatureofApplicant: Date: - P-5-2-60a <br /> MPCA Certification No.: <br /> Staff Review: Ap oval Denial <br /> Reviewer: P Date: 7- 2 5- 00 <br /> Reason for Denial: <br />