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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> �D 1. I have received a copy of the system design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I will be installin; the following: <br /> A. Tanks: � Precast Concrete _ Other Manufacturer <br /> Tank Capacities: 1)� gaI. 2) � gal. 3) �_ gal. <br /> B. Pump Station (if required) <br /> Pump make & model � 2/ �;�5 (attach pump curve & <br /> literature); system desi�n requires �b jpm � feet of head. <br /> High water alarm make & model _�L,�� Outside <br /> � ' electrical work to be completed by installer �_ electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " ock bed dimensions l`o 'x.,f`'�S�' <br /> Drop Boxes Sand bed dimensions ,s� 'x �.�' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Maniford Pipe Diam. p°C " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> x 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 cenifies that all statements made on this application <br /> are complete, true and correct. <br /> Si�natureofApplicant: Date:C��Z���� <br /> MPCA Certification .• o�-/�/ <br /> Staff Review: Appr val .�' De 'al <br /> , <br /> � r' <br /> Reviewer: �� Date: ��'� � <br /> Reason for Denial- <br />