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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> b es. <br /> ((k.._ designincluding <br /> 1. I have received a copy of the system the City of Orono Septic <br /> System Approval Cover Sheet. <br /> tt- <br /> ----A.v,..t.,,'I.,, <br /> 2. I will be installing the following: <br /> A. Tanks: ecast Concrete Other Manufacturer <br /> Tank Capacities: 1) % gal. 2) /9f f°) gal 3)/ gal <br /> B. Pump Station (if required) <br /> Pump make& model ,Ou/di PE-5..,/ (attach pump curve& <br /> literature); system design requires Z 1 gpm at S— feet of head. <br /> High water alarm make &model S.3-, (214,.6 vs . Outside <br /> electrical work to be completed by installer ectrician other. <br /> C. Treatment System: �- <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions/0 ' x 38 ' <br /> Drop Boxes Sand bed dimensions tri5- ' x 3 B ' <br /> Distribution Box Pressure Dist. Pipe Diam. / /C- " <br /> Manifold Pipe Diam. -Z " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system installation permit, <br /> agrees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Minnesota,and certi - •t all .tements .de on this . .• ' ation are complete,true and correct. <br /> Signature of Applicant tito_1 Date: <br /> MPCA License No. isco <br /> \/ <br /> Staff Review: Approval Denial <br /> %/G 4‘31,,/ <br /> Reviewer: Date: 7- 3/-cC <br /> Reason for Denial: <br />