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CITY OF ORONO IS 6122494616 01/07/00 16:33 5 :03/03 No:604 <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes, <br /> YE$ — I, 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 installi4 the following: )3q7 <br /> A. Tanks: V Precast Concrete _ Other / Manufacturer..de 4_ �1Q'"'� <br /> Tank Capacities: 1) (4.47 gal. 2)�. bgal. 3)112,::7,,c4 gal. <br /> B. Pump Station (if required) %,-----s-40 e9/ <br /> Pump make & model 6. „Lt„.."_________ (attach pump curve & <br /> literature); system design requires <br /> .-.c/ gpm at 2i. feet of head. <br /> High water alarm make & model 4-y,,s ,, . Outsi <br /> el:ctrical work to becompleted by installed electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> _ Trenches: s.f. V' Mound <br /> Depth of rock below pipe _ ” Rock-bed dimensions 'x &I' <br /> Drop Boxes Sand bed dimensions y 'x //o' <br /> Distribution Box Pressure Dist. Pipe Diam. 2 " <br /> Maniford Pipe Diam. Z " <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 /> SignatureofApplican u ,-44, Date: /— 7--2c o <br /> MPCA Certification No.: .39 9- <br /> Staff Review: p t val ai _ Denial � _ <br /> � ; r <br /> Reviewer: I .' _ _ Date: i— i - &C,C) <br /> Reason for Denial: <br />