Laserfiche WebLink
NOTE: Appltcant must initial alI spaces. Fill in a11 appropriate blanks, check all appropriate <br /> boxes. <br /> 1. I have received a copy of the system desi�n includin� the City of Orono <br /> Septic System Approval Cover Shee[. <br /> 2. I will be installin� the followin�: <br /> A. Tanks: � precast Concrete O[her Manufacturer �f G��, <br /> Tank Capacities: 1) � , � gal. 2) :� �-� �al. ;) ga1. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system desi�n requires opm at feet of head. <br /> Hi�h water alarm make & model Outside <br /> • electrical work to be completed by installer electrician <br /> other Inside electrical work must be completed by <br /> eleccrician. <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. " <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 undersi�ned 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 [hat all statements made on this appiication <br /> are complete, true and correcc. , <br /> , ;% <br /> , <br /> SignatureofApplicant: ��, � ! _� Date: �'�" �- �7,� <br /> � <br /> MPCA Certification No.: � �.C% <br /> Staff Review: Appro aI Deni <br /> . � _� ��j- � <br /> Retizetiver: �-- <br /> i" �"-7 <br /> ; ��� �� ��' Date: � L, <br /> Reason for Den.ial: <br />