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• <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 /> 2. I will be instal ing the following: <br /> A. Tanks: - Precast Concrete _ Other Manufacturer gal. <br /> Tank Capacities: 1) v gal. 2) /� -; gal. 3) <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system design requires (IO gpm at /'j feet of head. <br /> High water alarm make & model . Outside <br /> electrical 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 /i% ')C- ' <br /> Drop Boxes Sand bed dimensions <br /> Distribution Box Pressure Dist. Pipe Diam. <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 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 co ) <br /> / '�%/� _ — Date: `� / <br /> Signature ofApplicant:, 47, <br /> MPCA Certification No.. <br /> Staff Review: Approv. ✓; \ Denial <br /> AllireAV <br /> Reviewer: ✓ �r�� <br /> Reason for Denial: <br />