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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> '--'/ l. I have received a copy of the system desi�n includin� the City of Orono Septic <br /> System Approval Cover Sheet. <br /> 2. I�vill be install�i � the follo�vin�: <br /> A. Tanks: i/ Precast Concrete Other Manufacture <br /> �xJGe���cr� <br /> Tank Capacities: 1) r�� �al. 2)�f1 � �al 3) OC� �al <br /> B. Pump Station (if required) c, <br /> Pump make& model ��'�,�/� `� (attach pump curve 8c <br /> literature); system desijn requires jpm at feet of head. <br /> High water alarm make & model . Outside <br /> electrical work to be completed by installer electrician other. <br /> C. Treatment System: <br /> Trenches: s.£ 1�Iound <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 /> Manifold Pipe Diam. " <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 permit, <br /> a�rees to do all �vork in strict eordance with ordinances of the City and the re�ulations of the State <br /> of i�Iinnesota,and certifies th t all statements ade on this application are complete,true and correct. <br /> Si�natureofApplicant G Date: ��/ 2��� <br /> IvLPCA�,icense I�+To. <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> � ;'. <br /> S�a£�'�ev�e���: �p��-oea� - �enIl�a� <br /> �'. ---� <br /> ���-u�������; � !'`���/ _ - ��atea � �� / U � <br /> ���son '�o�� �rP��a�: <br />