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`� a,,� ��� ��. <br /> I will be installing the following: <br /> Tanks <br /> Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: / pc•e^"i 144-`"- <br /> Size <br /> f4-`Size of Tanks: .er.s j / 4:20 hr /eel.) /0c0 i V'f <br /> Treatment System <br /> Trenches s.f. <br /> Mound s.f. i a 3 V- <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 /> L.- 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 Date: 6 - 2-5 —�� <br /> MPCA License No.: `f O <br /> Staff Review: [VAccept ❑ Denied <br /> Reviewer: 4/, }",e_„ Date: 6 6-- 034 <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 2 / 2 <br />