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�. � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> 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 installina the following: <br /> A. Tanks: x Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) t 3c� gal. 2) vo gal. 3) vo �al. <br /> B. Pump Station (if required) <br /> Pump make & model l�'�C- �/� - ►'k�ers (attach pump curve & <br /> literature); system design requires 3 9 gpm at / g feet of head. <br /> Hi�h water alarm make & model G-c.�7P�.-� . Outside <br /> electrical work to be completed by installer electrician ?� <br /> other Inside electrical work must be completed by <br /> elec[rician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound <br /> Depth of rock below pipe " Rock bed dimensions /v 'xb�' ' <br /> Drop Boxes Sand bed dimensions ��0 'x �O�' <br /> Distribution Box Pressure Dist. Pipe Diam. �. S �� <br /> Maniford Pipe Diam. � " <br /> D. Final Cover/Topsoil to be: 1� borrowed from site <br /> (show location on site plan) <br /> trucked in <br /> The undersigned hereby applies to the Ciry 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 /> SignatureofApplicant: V��-�� � ����'`'`" Date: � <br /> MPCA Certification No.: �`��' <br /> Staff Review: Approv,�l Denial <br /> - � ��- �_ <br /> Reviewer: ��� Date: � <br /> Reason for Denial: <br />