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.► <br /> NOTE: �Applicant rriust initial alI spaces. Fi1i in aIl appropriate blanks, check all appropriate <br /> boxes. . <br /> 1. I have received a copy of the system desi�n including the Ciry of Orono <br /> Septic Sys[em Approval Cover Sheet. � <br /> - � � � .2. T �viIi be�iastallin� thz followins:�� � . <br /> A. Tanks: Pcecast Concrete Other Manufacturer <br /> Tank Capacities: 1) gaI. 2) QaI. ^ <br /> J ,) a�i, . <br /> � - B• Pump Station (if required} <br /> Pump make & model • (attach pump curve & <br /> literature); system desi�n requires gpm at feec of head. <br /> . Hi�h Svacer alarm make & model Outside <br /> • electricaI work to be completed by installer electrician <br /> other . Inside electricai work must be completed by <br /> electrician. � <br /> ' C. Treatment System: <br /> � 1����j , Trenches: s.f. �Mound <br /> �� ��,�1 Depth of rock below pipe " Rock bed dimensions ��X � <br /> � Y v�w ��s�,,,� ^� � Drop Boxes � Sand bed dimensions 'X ° - <br /> 1�`_ Distribution Box Pressure Dist. Pi e Diam. T-" <br /> �,,bY�� � ��' . P r �i. <br /> v,�� '` � .Maniford Pipe Diam. � " <br /> D. Final Cover/Topsoil to be: borrotved from site <br /> (show location on site pla�)- � <br /> _�trucked in <br /> The undersi�ned 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 /> �� <br /> Si�na[ureofAppIicanc:_�_ �_ - _ � �, <br /> - . Date: 7 �-- � " � S <br /> � . . � <br /> MPCA Certification No.: � � (J . - - � <br /> Staff Reriesv: Approval �� Denial . . � <br /> � ReFiesver: � " ' � � <br /> � Date: '� - ?� � S�� <br /> Reason for Denial• <br />