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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 design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: 3 Precast Concrete Other Manufacturer _'_`c`` f "'Yr---X. <br /> Tank Capacities: 1)(e-o.c gal. 2)("0c;o gal. 3) (mid gal. <br /> B. Pump Station (if required) <br /> Pump make & model v •:–(c3- _ (attach pump curve & <br /> literature); system design requires 31 gpm at /7 feet of head. <br /> High water alarm make & model . AA r ,{ .,r , . Outside <br /> electricaI 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 (c 'x4( ' <br /> Drop Boxes Sand bed dimensions cLc 'x 71 ' <br /> Distribution Box Pressure Dist. Pipe Diam. Z' <br /> Maniford Pipe Diam. 2. " <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 /> Pete r5a,? CO, <br /> SignatureofApplicant:7 <br /> ,i),Za-4 Date: 7°' ' ce 2. <br /> MPCA Certification No.: <br /> Staff Review: Approv Denial <br /> /Avg,/ 1 • • <br /> Reviewer: !/ . /. //li7 Date: 7—/ ? <br /> Reason for Denial: <br />