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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate � <br /> boxes. <br /> �S 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 installing the following: <br /> A. Tanks: � Precast Concrete Other Manufacturer �u�'4� <br /> Tank Capacities: 1) 3�� gal. 2) �c.,�l gal. 3) � 3� gal. <br /> B. Pump Station (if required) ��� <br /> Pump make & model �� ���rsc, 7 ��e`� � (attach pump curve & <br /> literature); system design requires � gpm at - u feet of head. <br /> High water alarm make & model �-���-,- 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. X Mound �c��U� � <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 /> Maniford 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 <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 conect. <br /> � I / � <br /> SignatureofApplicant: �C.�-, � Date: � " lv - «' <br /> MPCA Certification No.: � .�� <br /> Staff Review: Approval Denial <br /> Reviewer: Date• <br /> Reason for Denial: <br />