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. � <br /> NOTE: Applicant must initia] all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> �=�n�a.l C-s��2��r>r t�o� ��s C�Y le (S,1-..,��t 7-`�c,_i•���J <br /> �__ 1. I have received a copy of the system design including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> ��`J 2. 1 will be installing the following: <br /> A. Tanks: x Precast Concrete Other Manufacture��d�/r� �.P�� <br /> Tank Capacities: l)�,��51"c gal. 2) E9rd gal 3) /S� gal <br /> B. Pump Station (if required) <br /> Pump make & model��c,yr�� ��/�,q</ (attach pump curve & <br /> literature); system desig rn equires tfZ� gpm at�� feet of head. <br /> High water alarm make & model �F ,��y(�,/gc,�' �'�,E- �r,1: Outside <br /> electrical work to be completed by installer�electrician other. <br /> �1��.� ���.�-� <br /> C. Treatment System: j <br /> Trenches: s.f. � ` Mound <br /> Depth of rock below pipe " Roc d dimensions /� ' x 6� ' , <br /> Drop Boxes Sand bed dimensions f�' x��'x yJ � <br /> Distribution Box Pressure Dist. Pipe Diam. -Z " <br /> Manifold Pipe Diam. L " <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 instal lation permit, <br /> agrees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application are complete,true and correct. <br /> Signature of Applicant Date:/a�p`d,� <br /> MPCA License No. ��{2�/Z�3�l <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staff Review: Approval Denial <br /> Reviewer: "J�Y�0.� Date• � b- 1 � -' d � <br /> Reason for Denial: <br />