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. <br /> . .I <br /> N01'E: 'Applicanc rriust initial alI spaces. Fill in aIl appropriate blanks, check alI appro riate I <br /> boxes. . p � <br /> �� 1. I have received a co of the s 'o - <br /> py ystem desi�n including the Ciry of Orono <br /> Septic System Approval Cover Sheec. � , <br /> . �. <br /> .2. I wiIl be�ins�tallin�Q �z followinQ:`� : - . � <br /> A. Tanks: ✓�zecast Concrete Ocher ivianufactu � ���✓ I1 <br /> Tank Capacities: 1) ; � Qaj_ 2 . � , o ^ rer%�' <br /> .�� ) C ! �al. �) ' t�G gal; I <br /> - B- Pump Station (if required) I <br /> Pump make & model a,.(c� �,,�C p3�� � <br /> (attach pump curve & � <br /> licerature); system desi�n requires 3 gpm at � feet of head. <br /> Hi�h tivater aIarm make & model C�,;��,���,� Outside i <br /> • ' electrical work to be completed by installer <br /> ocher eleccrician i <br /> . Inside electrical tvork must be comple[ed by ' <br /> electrician. � ', <br /> ' C. Treatment System: ; <br /> � Trenches: s.f. �/ Mound <br /> Depch of rock below pipe " Rock bed dimensions �p -'X�� ° I� <br /> Drop Boxes � Sand bed dimensions �z 'x�' - <br /> Distributivn Box Pressure Dis[. Pipe Diam. � /`�" <br /> � � .Ma ' ord Pipe Diam. :Z: n <br /> D. Final Cover/Topsoil to be: borrotved from site <br /> (show location on sice plan)- � <br /> trucked in <br /> The undersigned hereby appIies to the Ciry of Orono for issuance of a sep[ic system installation <br /> permit, a�rees to do all work in s[rict accordance wich the ordinances of the City and the <br /> reguIations of the State of Minnesota, and cercifies thac all statements made on this application <br /> are complete, true and correct: <br /> �-`� � � �v � t �� � � <br /> Si�na[ureofApplicant: Date: <br /> MPCA Certif cation No.:_ Lp � � . . - � <br /> � � i <br /> Staff Revieiv: Appr v Denial . . � <br /> � ReFiesver: � ., . J � . - <br /> � � Date:_ Z�����_ <br /> Reason for Denial• I <br /> . . � <br /> ' � - I <br />