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/ � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> '�n f- <br /> _ 1. I have received a copy of the system design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> nr <br /> 1� � � 2. I will be installing the following: <br /> A. Tanks: �Precast Concrete _ Other Manufacturer .�//s <br /> Tank Capacities: 1) "/ZS�G, gal. 2) �G�/ c',G, gal. 3) �7 O gal. <br /> B. Pump Station (if required) <br /> Pump make & model lr,{�,l��s u.'�v:�ii h'- (attach pump curve & <br /> literature); system design requires � gpm at l�� feet of head. <br /> High water alarm make & model ��,��,��� S,c-�,�,�r;� _. Outside <br /> electrical work to be completed by y 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 j D 'x �;� ' <br /> Drop Boxes Sand bed dimensions �'�'x �=/' <br /> Distribution Box Pressure Dist. Pipe Diam. Z._ " <br /> Maniford Pipe Diam. 2 " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> � 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 correct. <br /> � <br /> SignatureofApplicant: =7� Date: - 5 �'�� _ <br /> MPCA Certification No.: � Z�� <br /> Staff Review: Ap�v 1 / Denial <br /> - G' <br /> Reviewer: Date: �- 3 ' O� <br /> Reason for Denial: '�— <br />