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•�,,. <br /> 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 includin� the Ciry of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I will be installin; the followinQ: <br /> A. Tanks: `� Precast Concrete _ O[her Manufacturer ��ccuS'l� <br /> Tank Capacities: 1) r�c� gal. 2) 3�o gal. 3) j�� gal. <br /> B. Pump Station (if required) <br /> Pump make & model 1�'1��� �'lC����s (attach pump curve & <br /> literature); system desi�n requires 3� gpm at 1S feet of head. <br /> High water alarm make & model G ao�-2�� Outside <br /> � ' electrical work to be completed by 'K installer electrician � <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatmen[ System: <br /> Trenches: s.f. � Mound <br /> Depth of rock below pipe " Rock bed dimensions �� 'x 6�' �0 <br /> Drop Boxes Sand bed dimensions 'x ' `f`� <br /> Distribution Box Pressure Dist. Pipe Diam. 1��' " !�6 <br /> Maniford Pipe Diam. 'Z. " <br /> D. Final Cover/Topsoil to be: ?C borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> The undersi�ned 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 correct. <br /> SignatureofApplicant: V� ��� Date: '�^Z�- �7 <br /> MPCA Certification No.: g�.�� <br /> Staff Review: Appr v 1 Denial <br /> ___ � <br /> Reviewer: Date: ������j <br /> Reason for Denial: <br />