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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 insta.11ing the following: �S�-ll r��.6P,r�l��� <br /> A. Tanks: �_Precast Concrete �Other Manufacturer'���5 <br /> Tank Capacities: 1) iS vv gal. 2) gal 3) gal <br /> B. Pump Station (if required) <br /> Pump make & model ����,�-,,�,� 2,�, v�,�- (attach pump curve& <br /> literature); system design requires gpm at feet of head. <br /> High water alarm make&model . Outside <br /> electrical work to be completed by installer n electrician other. <br /> C. Treatment System: -�,��;�k,,�,�,� L�„� ,,,,�r�; <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. 7_" " <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 statements made on this application are complete,true and conect. <br /> � <br /> SignatureofApplicant • Date: S`�S'�3 <br /> MPCA License No. �Co 3'� <br /> ------------------------------------------------------------------------------------------------------------------------- <br /> StaffReview: Approval Denial <br /> Reviewer: Date• � <br /> Reason for Denial: <br />