Laserfiche WebLink
i <br /> NOTE: Applicant must irutial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> l. I have received a copy of the system design including the Ciry of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I will be installin� the following: <br /> A. Tanks: �° Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) � gal. 2) �'�t_7 gal. 3)/d ap gal. <br /> B. Pump Station (if required) <br /> Pump make & model (atta,�h.�timp curve & <br /> literature); system design requires gpm t � feet of head. <br /> High water alarm make & model Outside <br /> electrical work to be completed by installer electrician � <br /> other Inside electrical work must be completed y <br /> electrician. - • <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions �f 'x v� <br /> Drop Boxes Sand bed dimensions �'x�' <br /> Distribution Box Pressure Dist. Pipe Diam. � " <br /> Maniford 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 <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 /> Signature ofApplicant: Date: ��_ <br /> MPCA Certification No.: �'�� <br /> Staff Review: Approval - Denial <br /> i , ��i - <br /> Reviewer: - - �� - �- /-� �; -- Date: ��,,;'; ��,� <br /> ,'..j .,�; <br /> Reason for Denial• <br />