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•.� ��-�`2 ,.«f,@ � 'ize'r :ire' i y ', bd, u '�`"� <br /> .y.• , � a"' ;saI� a ` ia•= (�x"' � 7 777:77:71 <br /> , 7 ry '+ I <br /> 717"737:7177 <br /> y A..:7, <br /> 7°s° 5 <br /> 1a r. -,�a <br /> .. -. <br /> I will be installing the following: <br /> Tanks <br /> /Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: <br /> Size of Tanks: / l2U /./e) <br /> Treatment System <br /> Trenches tss.f. <br /> Mound '•_-ii►:y Q.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 • -c . <br /> Signature of Applicant i ,� i J Date: � I � o f <br /> cl <br /> MPCA License No.: <br /> Staff Review: ccept ❑ Denied <br /> Reviewer: 4,/,,e,,Ci(. 674. Date: 7-L 22 o - <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic System Permit Application.doc <br /> 2 /2 <br />