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��������+� . <br /> It��f 1M�'A��#� ,�'��C�;;`��.,,,,,�,,, <br /> �#�4��t�f�it�����1 <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> ll,� t�" l. I have received a copy of the system design including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> 2. I will be installinj the following: <br /> A. Tanks: Precast Concrete Other Manufacturer �%� ' � �C' <br /> Tank Capacities: 1) j pCx; jal. 2)/�avc"- gal 3) jal <br /> S7�o �."F"f <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curt-e 8c <br /> literature); system desijn requires gpm at feet of head. <br /> High water alarm make & model . Outside <br /> electrical work to be completed by installer electrician other. <br /> C. Treatment System: ��� <br /> Trenches: s.f. I �l� l�Iound <br /> Depth of rock below pipe " Rock bed dimensions ' x ' <br /> Drop Boxes Sand bed dimensions ' x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pipe Diam. " <br /> D. Final Cover/Topsoil to be: borro�ved from site <br /> (show location on site plan) <br /> � trucked in <br /> The undersigned hereby applies to the Gity 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 IVlinnesota,and certifies that all statements made on this application are complete,true and correct. <br /> Signature of Applicant Date: <br /> iVIl'CA License I�,To. <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> 5��$;f�e�ae«�: ���rova9 �enfi�� <br /> ��-7 <br /> �'��v��g��a-o �� �' ��� ��te: �—����'�—' l <br /> �e�so�a ucaa• �P�a��: <br />