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!� + <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxe <br /> � l. 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 install' the following: ���ST- <br /> A. Tanks: Precast Concrete Other Manufacturer :, �,v <br /> Tank Capacities: 1) �;�s� gal. 2) i v�a gal. 3) '21 SG gal. <br /> B. Pump Station (if required) <br /> Pump make & model �'����i��;,,,�� �o/(P. (attach pump curve & <br /> literature); system design requires �;'� gpm at �(p feet of head. <br /> High water alarm make & model ��.L:�' i�,��y�� 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 �'x�' <br /> Drop Boxes Sand bed dimensions �'x ��, ' <br /> Distribution Box Pressure Dist. Pipe Diam. j ' z " <br /> Maniford Pipe Diam. Z " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> l,/ 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 correc <br /> SignatureofApplicant: ` ` ���� Date: r� — /�-y� <br /> MPCA Certification No.:� 7(�� <br /> Staff Review: Ap oval Denial <br /> � 1 Date: /a-13-q <br /> Reviewer: Z� � <br /> Reason for Denial: <br />