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_..� � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> y-e--� 1. I have received a copy of the system design includin� the City of Orono <br /> '-- Septic System Approval Cover Sheet. <br /> 2. I will be installinQ the following: n <br /> A. Tanks: 3 Precast Concrete Other Manufacturer I're��uS <br /> Tank Capacities: 1) �.�% gal. 2) i 3�tJ gal. 3) f 3� gal. <br /> B. Pump Station (if required) <br /> Pump make & model J�'lE' `((� (attach pump curve & <br /> literature); system design requires Ll7 �pm at I� 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 by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound ,,- <br /> Depth of rock below pipe " Rock bed dimensions I(� 'x��� ' <br /> Drop Boxes Sand bed dimensions 3� 'x,�S ' <br /> Distribution Box Pressure Dist. Pipe Diam. /jz �� <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 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 /> , <br /> i natureofA licant: �����v � � Date: / �_ �� —��� <br /> S g PP <br /> � <br /> MPCA Certification No.:� `�� 2 � <br /> Staff Review: Approv Denial <br /> � l� �..�� <br /> Reviewer: ' �� Date:_—s�� <br /> Reason for Denial• <br />