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i° <br /> 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 design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> Lg 2. I will be installin; the following: <br /> A. Tanks: x Precast Concrete Other Manufacturer ELT,i S <br /> Tank Capacities: 1) � a <br /> gal./ 2) poo gal. 3) al. <br /> B. Pump Station (if required) <br /> Pump make & model SP40 HYDROMATIC (attach pump curve & <br /> literature); system design requires 4 6.6 gpm at 16 feet of head. <br /> High water alarm make & model SJE TANK ALERT I. Outside <br /> electrical work to be completed by installer X electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. _X Mound <br /> Depth of rock below pipe " Rock bed dimensions 10 'x_E21,' <br /> Drop Boxes Sand bed dimensions �W'x_ aa' 36'X- <br /> Distribution Box Pressure Dist. Pipe Diam. _lam" r <br /> Maniford Pipe Diam. 2 <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> X 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 /> Signature ofApplicant: Date: <br /> S—,,,?` ^g?— <br /> MPCA Certification No.: 1384 <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />