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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> �� � � <br /> L �- ) 1. I have received a copy of the system desi�n including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> �� � 2. I will be installina the followinQ: <br /> J ., ��k5��- <br /> A. Tanks: =��- Precast Concrete �Other �_ Manufacturer ���5« <br /> Tank Capacities: 1) �? �al. 2) __��gal. 3) � gal. <br /> l�zs� �,�a � �(A, <br /> B. Pump Station (if required) �-�--�i�Y1� �� <br /> Pump make & model �-�,��/�( i��i�'�� ��IG�� <br /> literature); system desi;n requires =/Z jpm at 3 J feet of head. <br /> High water alarm make & model , ;yy����� ,,_ >,�,,�,�,�� Outside <br /> � ' electrical work to be completed by installer electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. =� Mound �5 <br /> Depth of rock below pipe " Rock bed dimensions rr� 'x�'Y3��l? <br /> Drop Boxes Sand bed dimensions yo 'x� <br /> Distribution Box Pressure Dist. Pipe Diam. �_" <br /> Maniford Pipe Diam. Z " <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 �vith 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 /> , <br /> SignatureofApplicant: ��1���� �� �-- Date: � � �, - %� <br /> MPCA Certification No.: �7 ,S� <br /> Staff Review: Approva Denial <br /> � <br /> Reviewer: v Date: � o�(�"�� <br /> Reason for Denial: <br /> � <br />