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. �. <br /> 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 /> System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A. Tanks: � Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) gal. 2) gal 3) ga1 <br /> B. Pump Station(if required) <br /> Pump make& model (��(,(,�� (attach pump cur�-e& <br /> literature); system design requires ��' a gpm at=�'�feet o�head_ <br /> High water alarm make&model �,�vc�, r�L r���'1 . Outside <br /> electrical work to be completed by installer � electrician other_ <br /> C. Treatment System: <br /> Trenches: s.f. � Mound <br /> Depth of 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 /> agrees 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 st tements made on this application are complete,true and correct <br /> _ ,� <br /> Signature of Applicant �-�� ����� ��. Date: ��� 7 �%� <br /> MPCA License No. ���1� <br /> --------------------------------------------------------------------------------------------------------------------- <br /> Staff Revie�v: Approval Denial <br /> Reviewer: ����.�L �- �_� Date: � ` c��`'��L `1 <br /> Reason for Denial: <br />