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� . ! <br /> NOTE: Applicant musc initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> �' �� l. I have received a copy of the system desi�n includi.ng the City of Orono <br /> Septic System Approval Cover Sheet. <br /> };�� <br /> ��/� 2. I �vill be installin� the followin�: <br /> A. Tanks: Precast Concr te� t r Manufacturer <br /> Tank Capaci[ies: 1) ��`t 2 Ge.t�t, 3) �al. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); syster.� desi�n requires gpm at feet of head. <br /> Hi;h water alarm make & model Outside <br /> � ' electrical �vork 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 %l� 'x�j' <br /> � Drop Boxes Sand bed dimensions 3� _'x / � ' <br /> Distribution Box Pressure Dist. Pipe Diam. ��2 " <br /> Maniford Pipe Diam. =�" <br /> D. Final Cover/Topsoil to be: bonowed from site <br /> (show location on site plan) <br /> trucked in <br /> The undersijned hereby applies to the City of Orono for issuance of a septic system installation <br /> permit, a�rees 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 /> SiQnatureofApplicant: ��2�� �� � Date: _`7_ �.Z �"� �'� <br /> � -�� <br /> `-7 <br /> MPCA Certification No.: � <br /> Staff Review: Approval Denial <br /> _ � <br /> Reviewer: Date: ���'" / <br /> � <br /> Reason for Denial: <br />