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NOTE: �Applican[ rrius[ initial all spaces. Fill in all 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 Sheet. � <br /> � .2. I �vill be installin; che followinQ: � � <br /> A. Tanks: � precast Concrete Ocher Manufacturer � ��-w�K <br /> Tank Capacities: 1) I u�j gai, 2) �_ Jal. ;)�_ Q21.° <br /> a , <br /> B- Pump Station (if required} <br /> Pump make & mvdel %i �,�e-s�. �t E s`� (attach pump curve & <br /> literature); system desi�n requires �_ gpm at /z feet of head. <br /> , High �vater aIarm make & model G�; Outside <br /> � electrical work to be completed by installer electrician �C <br /> ocher . 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 io 'x .5� ' <br /> Drop Boxes Sand bed dimensions 3 g 'x �z � F�y - <br /> Distribution Box Pressure Dist. Pipe Diam. �`/i.. " <br /> Manifo�d Pipe Diam. 2 ° <br /> D. Final Cover/TopsoiI to be: borrowed from site <br /> (show location on site plan)- � <br /> _� trucked in <br /> The undersi�ned hereby appIies to the City of Orono for issuance of a sep[ic 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 cha[ aIl statements made on this appiication <br /> are complete, true and correct: <br /> Si�natureofApplicant: �2�-,-� �. (�,Y��,,,�. Date: /'(� '" Z�—cCQ <br /> MPCA Certif cation No.:_ �.5� . - � <br /> Staff Review: Ap ov be�� � <br /> Revie�ver: Date:_ �0-21�-9q <br /> � <br /> Reason for Denial: <br />