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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> � 1. I have received a copy of the system design including the City of Orono Septic <br /> ��i� <br /> System Approval Cover Sheet. <br /> ��� 2. I will be installing the following: � � <br /> A. Tanks: -� Precast Concrete Other Manufacturer�A�'�✓�j^ <br /> Tank Capacities: 1)�gal. 2) i3ot� gal 3)�gal <br /> B. Pump Station (if required) <br /> Pump make& model��v�� ����� (attach pump curve& <br /> literature); system design requires 3 gpm at�feet of head. <br /> High water alarm make&model_� �(ccr.�-� . Outside <br /> electrical work to be completed by installer �/ electrician other. <br /> C. Treatment System: <br /> G�-n,,.e12 Sj Trenches:�33 s.f. Mound <br /> Depth f 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: � 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 permit, <br /> a�rees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Minnesota,and certifies that all statement ade on this application are complete,true and correct. <br /> SignatureofApplicant Date: �P "� 2- � � S� <br /> MPCA License No. � `�0 <br /> ------------------------------------------------------------------------------------------------------------------------- <br /> Staff Review: Approval_S„��� Denial <br /> Reviewer: v(�t/_�� �%�'�� Date• � "-�/ '�� � <br /> Reason for Denial: <br />