Laserfiche WebLink
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 /> , ,44------- <br /> ------1 <br /> 7 2. I will be installing. the following: <br /> A. Tanks: t/ Precast Concrete _ Other Manufacturer <br /> Tank Capacities: 1)/06-0 gal. 2) /coo gal. 3) /Ec, gal. <br /> B. Pump Station (if required) } <br /> Pump make & model ( ;u1.1 li)L03 1 ) '/3 a(attach pump curve & <br /> literature); system design requires 2/O gpm at /3 feet of head. <br /> High water alarm make & model ,Le. I Ale w, . Outside <br /> electrical work to be completed by installer electrician <br /> other oy.c . 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 /p 'x gam' <br /> Drop Boxes Sand bed dimensions 3g 'x F3 ' 4v-e <br /> Distribution Box Pressure Dist. Pipe Diam. (1E--" <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 /> s--------7 OP <br /> Signature of Applicant: 'r two.- Date: 5 _ <br /> / <br /> MPCA Certification No.: ? y <br /> Staff Review: Approv. / Denial <br /> Reviewer: 17%# °' Date: (✓�"' <br /> Reason for Denial: <br />