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� <br />� ' <br /> � � � ,�} _,� <br /> � : <br /> � � sES � <br /> _ � '`'�. �'�'� � �'' r,X''_ �z `x v- 1 {»��;t� <br /> . `7.Y�'+1 p.A,. '-N�fa � - . h 9� =-4, d," 1 � ''.f.r. � 1 F <br /> �.. �l ) .4.. ��r <br /> I wiii be instalting the fo[towing: <br /> Tanks <br /> � Precast Concrefe ❑ Fil�ergtass ❑ P[astic [] ather <br /> t�� <br /> Number of Tanka: � <br /> SfZ@ Of�fBFtkS' ���GAL-SF� 1500 GAL-SE� 1004 GAL-LtF� <br /> Treattnetrt System <br /> � Trerrches s.f. <br /> �✓ _ Mound �2 s.f. <br /> � Gravelless s.f. <br /> �, Chamber s.f. <br /> Final Cover I Top 3oil <br /> ✓� to be borrowed from site (show loeation on site pian) <br /> �✓ _ trudcecf in <br /> The undersigned hereby applies to th� City of Orono for issuance of a septic system <br /> insfa�fatior� permit, agcees to do aFt the vvork m str�ct accordartce with ord�r�ances of the City <br /> and regulations of the State of Minnesota and vertifies that all statements made an this <br /> appticafion are complete, true and correct. <br /> Signature of Appficant ��-a �v U YD�.1�.� Date: �3� � � � ��� <br /> MPCA License No.: 1—��� � <br /> Staff Revie�w: A� 0 [?enfed <br /> Revievver: Date:___�� ��C�s <br /> Reason for Denial- <br /> Comments (to be printed on ir�pect�on card): <br /> �� V:�(Perm�s)lSeptic System Pemiit Appfica�on.doc <br /> 2�2 <br />