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-"vCT-s <br />; . <br />NOTE: Applicant must initial all qwces. FiU in aM appropriate blanks, check aM appropriate <br />boxes. <br />ytfs 1. 1 have received a copy of the system design including the City of Orono <br />Septic System Approval Cover Sheet. <br />yes 2. 1 wUl be ins^ing the followiiig: <br />A. Tanks: 3 Precast Concrete Other Manufacturer <br />Tank Capacities: 1) /?U^ gal. 2) gal. 3) gal* <br />^ -iO (attach pi^ cun^ <br />literature); system desip requires _ ffl>m at_____feet Outside <br />installer____electrician V <br />Hip water alarm make & model <br />electrical work to be completed by-------------------- ------ <br />other __________• electrical work must be completed by <br />electrician. <br />C. Treatment System: <br />Trenches:s.f. <br />Depth of rock below pipe <br />____Drop Boxes <br />____Distribution Box <br />X Mound <br />Rock bed dimensions / Q *x b* * <br />Sand bed dimensions l^o *x ¥L* <br />Pressure Dist. Pipe Diam. Jjxj' <br />Maniford Pipe Diam. X- " <br />D. Final Cover/TopsoU to be: K borrowed from site <br />(show location on site plan) <br />____trucked in <br />The undersigned hereby applies to the City of Orono for issuance of a septic system installation <br />permit agrees to do all work in stria accordance with the ordinances of the City and the <br />t^ulations of the State of Minnesoto. and certifies that aU statements made on this application <br />are complete, true and correct. <br />Dme: /D-ZS'^f^ tl QJl^ <br />MPCA Certification No.:.^_______ <br />Staff Re»few! Approval Denial <br />A' / IReviewer:Ym Date: <br />Ream far Denial:.