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IA4C P' ' ; gV < ,4;11 <br /> $ s •63• as- <br /> "$ <br /> I will be installing the following: <br /> Tan s <br /> Precast Concrete I I Fiberglass ❑ Plastic n Other <br /> (list manufacturer) <br /> Number of Tanks: 7 <br /> Size of Tanks: ( 250 <br /> Treatment System <br /> Trenches s.f. <br /> Mound /6 s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> Final Cover/ Top Soil <br /> to be borrowed from site (show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correct. _ <br /> Signature of Applicant .���� I�� �� �, Date: <br /> eco <br /> MPCA License No.: 03c() <br /> Staff Review: I Accept ❑ Denied <br /> Reviewer: / / 4110/1 Date: /(71' t'" 0 Cr <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic Permit Application-New Permit Fees 2009.doc <br /> 2 / 2 <br />