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� . <br /> NOTE: �Applican[ rriust initial all spaces. Fili in all appropriate blanks, check alI appropriate <br /> `�� . - <br /> � � <br /> I. I hav� received a copy of the system desijn includin� the Ciry of Orono <br /> Septic System Approval Cover Sheet. - <br /> �. : � � .2. I wiIl be�installin� thz followinQ:'� . : � : . . <br /> A. Tanks: �ecast Concrete Ocher i1�lanufacturer� <br /> Tank Capacities: 1) 3�U QaI. 2 ��-w'`"' <br /> -�_� )� ?aL �) 30U gaL. <br /> . � z� 6�/ <br /> � B• Pump Station (if required) <br /> Pump make & model ��� �// �3 � I�`(attach pump curve & <br /> literature); s ystem desi�n re quires opm at feet of head. <br /> Hi�h water alarm make & model L�� (4�-�., Outside <br /> • ' electricaI work to be completed by installer � <br /> other electrician <br /> . IrLside electrical work must be completed by <br /> electrician. � <br /> ' C. Treatment System: <br /> � ✓Trenches: izs y s,f, Mound <br /> `{/� L�hu,l Depch of rock below pipe " Rock bed di.mensions -'x ' <br /> /�r� _�"Drop Boxes � Sand bed dimensions 'x ' - <br /> Distribucion Box � Pressure Dist. Pipe Diaril. � " <br /> � � .Maniford Pipe Diam. � � " <br /> D. Final Cover/Topsoil to be: '—''rboRosved from site <br /> (show location on site plan)- - <br /> trucked in <br /> The undersi�ned hereby applies to the City of Orono for issuance of a septic system installation <br /> permit, a�rees to do all work in strict accordance wich the ordinances of the City and the <br /> . regulations of the State of Minnesota, and certifies that all sEatements made on this application <br /> are comple[e, true and correct: <br /> SignatureofAppIicant: Date: <br /> . . . _ ��zS^ "�� <br /> MPCA Certif cation No.: �, `{ � - � <br /> Staff Reriezv: A�rprov�� � Denial �. � <br /> , � <br /> � ReYieiver. �� � ��%GCC-C� � ' �. _ � . . <br /> � ,; Date: � �S �i, <br /> Reason for Denial• <br />