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, <br /> NOTE: Applican[ must irutial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> �S _ 1. I have received a copy of the system desijn including the Ciry of Orono <br /> Septic System Approval Cover Shee[. <br /> 2. I will be installing the followinQ: <br /> A. Tanlcs: �(' Precast Concrete _ Other Manufacturer /'�`�-c.c� S7L <br /> Tank Capacities: 1) �t� gal. 2) �� gal. 3) '�u� �al. <br /> B. Pump Station (if required) <br /> Pump make & model �'�l �33� ��-e�s (attach pump curve & <br /> literature); system desi�n requires � gpm at '�� fee[ of head. <br /> Hi;h water alarm make & model (r-�av{��., Outside <br /> � ' electrical work to be completed by _� installer electrician K <br /> ocher 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 d'unensions ( � 'x 6� ' �r 2 <br /> Drop Boxes Sand bed dimensions 'x ' �,3� <br /> Distribution Box Pressure Dist. Pipe Diam. /,r " �o Z <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, ajrees to do all work in strict accordance �vith 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: f�� (/�l� Date: '��g ? <br /> MPCA Certification No.: � �� <br /> Staff Revie�v: Approval � Deni <br /> Revie�ver: �� `� Date: ���'��►--�_,� <br /> Reason for Denial: <br />