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. � <br /> ' � <br /> NOTE: �Applican[ rriusc initial alI spaces. Fill in alI appropriate blanks, check alI appro riate <br /> b . . p <br /> 1. I have received a copy of the system desi�n includin� the Ciry of Orono <br /> Septic System Approval Cover Sheet. - <br /> � � .2. I wiIl _ Q . . <br /> be installin� thz followinQ:�- � <br /> A. Tanks: �precast Concrzte Ocher 11�Ianufacturer <br /> Tank Capacities: 1) `Z1 5c> �al. 2) �25u Q�1_ � � <br /> � ,) ��2.5�gai, . <br /> � � B• Pump Station (if required) <br /> Pump make & model � (attach pump curve & <br /> literature); system desi�n requires � o <br /> High �vacer aIarm make & model�- �Pm at �2 feet of head. <br /> • ' eIectrical work to be com Ieted b /� V E( �R� • Outside <br /> P y uistaller_� eleccrician <br /> ocher . Inside electrical work must be completed by <br /> electrician. . <br /> ' C. Treatment System: <br /> � Trenches: s.f. Mound <br /> Depch of rock below pipe " oc bed dimensions �' � <br /> Dro Boxes � X� <br /> P . � Sand bed dimensions 3��'x�' - <br /> Distribucion Box Pressure Dist. Pipe Diam. � " <br /> � .Maniford Pipe Diam. � " <br /> D. Fina1 Cover/Topsoil to be: borro�ved from site <br /> (show location on site plan)- � <br /> trucked in <br /> The undersigned hereby appiies to the City of Orono for issuance of a septic systern instalIation <br /> permit, a�rees to do aIl work in strict accordance jvich the ordinances of the City and the <br /> reguiations of the State of Minnesota, and certif es that all statements made on this application <br /> are complete, true an corre�t: <br /> � <br /> ��1__ j <br /> Si�natureofApplican[: c�t�� �'�� . <br /> . . Date: � �_ �-�� � <br /> MPCA Certif cation No.: - - � <br /> . <br /> Staff Reviesv: A ,�r vai Denial . . � <br /> �� <br /> � ReFiesver: ��' ' I �^ � . . <br /> Date: � <br /> Reason for Denial: � <br />