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� <br /> NOTE: �Applicant rriusc initial all spaces. FilI in all appropriate blanks, check all appro riate <br /> boxes. . p <br /> � � 1. I have . <br /> received a copy of the system design including the Ciry of Orono <br /> Septic System Approval Cover Sheet. � <br /> ��.. _ . . <br /> . �. � .2. I �vill be�installin�Q.��e."followin�:'. � _ . . <br /> A. Tanks: ./ycecast Concre[e Other Manufactu .- '�/ <br /> Tank Capacities: 1) a�,;; �al, 2 rer�� �u� <br /> ) Fc�� �al. ;)�o�i, <br /> - B• Pump Station (if required) <br /> Pump make & model /,uL cSl I � z ��P ` (attach pump curve & <br /> literature); system desi�n requires 3Sf opm at � 7 feec of head. <br /> Hi�h �vater alarm make & model ,,.� (,��w� 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 " Rock bed dimensions ,,�p -'x 5�' <br /> Drop Boxes � Sand bed dimensions �'x ' - <br /> Distribution Box -,-��-„ <br /> . Pressure Dis[. Pipe Diam. � <br /> � � .Man.iford Pipe Diazn. �_" <br /> D. Finai Cover/Topsoil to be: ✓borrotved from site <br /> (show location on site pla�)- � <br /> trucked in <br /> The undersi�ned hereby appIies to the City of Orono for issuance of a septic system installation <br /> permit, agrees to do all work in s[rict accordance wi[h the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all s[atements made on this application <br /> are complete, true and correct: <br /> Si�nacureofApplicant: � � <br /> . . Date. �^ ��—l� / <br /> MPCA Certification No.: ��� � . � . - � <br /> Staff Reviesv: Appr Deni . . � <br /> � ReFie�ver: ' � �!�l� � <br /> � �----' Date:� <br /> Reason for Denial• � <br />