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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br />boxes. <br />_ L I have received a copy of the system design including the City of Orono <br />Septic System Approval Cover Sheet. <br />2. 1 will be installing the following: <br />A. Tanks: Precast Concrete <br />Tank Capacities: 1)-�' ;al. <br />0 <br />� r? <br />Other Manufacturer��P <br />2) r. C' gal. 3)12 ��c' gal. <br />,-. -"L� A J <br />Fump Station (if required) h <br />Pump make & model A, c- : Me- CA (attach pump curve & <br />literature); system design requires gpm at feet of head. <br />High water alarm make & model L4E: •-•C•� _ Outside <br />electrical work to be completed by installer electrician <br />other electrician. Inside electrical work must be completed by <br />C. Treatment System: <br />Trenches: s.f. <br />Depth of rock below pipe <br />Drop Boxes <br />Distribution Box <br />Mound t c, <br />" Rock bed dimensions <br />Sand bed dimensions <br />Pressure Dist. Pipe 1)iam. f `12 " <br />Maniford Pipe Diam. <br />D. Final Cover/Topsoil to be: borrowed from site <br />X(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 strict accordance with the ordinances of the City and the <br />regulations of the State of Minnesota, and certifies that all statements made on this application <br />are complete, true and correct. <br />SignatureofApplicant:L Date: J <br />MPCA Certification No`:� C` <br />Staff Revie-ty: Approval Deni <br />Reviewer: c Date: <br />Reason for Denial: <br />