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ti <br /> 1 will be installing the following: <br /> Tanks <br /> ,�'Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> pist manufacturer) <br /> Number of Tanks: � <br /> Size of Tanks: /�� �oa a �OOO �.�� <br /> �. . <br /> _ . _�; ., . .. <br /> Treatment System ,,, ,, , ."��""� <br /> .._ . .. . �� . <br /> Trenches s.f. <br /> t <br /> � Mound f�X S S s.f. Q UF�(L A-�L '• �4( � g q <br /> �. :�, , <br /> Gravelless s.f. � <br /> Chamber s.f. <br /> �- �- �, �, <br /> Final Cover/Top Soil " �� � " ` � ' ^ <br /> � to be borrowed from site (show focation o� site plan) <br /> � Y trucked in �. ,` ..N._...` . _ ,. <br /> .� �., . �, .. y .. ;- <br /> The undersigned `hereby applies to the City of O�ono for issuance`of� a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true and correc <br /> Signature of Applicant Date: s � O ' <br /> MPCA License No.: �_ �� <br /> , ,�� _ <br /> StafF Review: [� Accept ❑ Denied <br /> Reviewer: _�, � < < �r � ��QS Date: ( �— r� O �( <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic System Pennit Application.doc <br /> 2 �2 <br />