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� ► <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes, <br /> � _ <br />, : <br /> � 1. I have received a copy of the system design including the City of Orono Septic <br /> - System Approval Cover Sheet. <br /> ��� . <br /> 2. I will be installing the following: <br /> A. Tanks: ✓Precast Concrete Other Manufacturer ����'�"� <br /> Tank Capacities: 1) j uC) gal. 2) /3GU gal 3) 13�G gal <br /> B. Pump Station(if required) , /� <br /> Pump make& model (����.l� /"�s (attach pump curve& <br /> literature); system design requires �-f 7 gpm at_� feet of head. <br /> High water alarm make& model � �. /Z�_.:,� 6� � . Outside <br /> electrical work to be completed by installer �electrician other. <br /> C. Treatment System: <br /> Trenches: s.f. ✓ Mound <br /> Depth of rock below pipe " Rock bed dimensions I � ' x�Z' <br /> Drop Boxes Sand bed dimensions �(� ' x �-' �n ` <br /> Distribution Box Pressure Dist. Pipe Diam. t %� " <br /> Manifold 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 permit, <br /> a�rees 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 st nts m d on this application are complete,true and correct. <br /> �--- `��, <br /> Signature ofApplicant Date: ��/�� "�Q� <br /> MPCA License No. � �� <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staff Revie�v: Approval Denial <br /> Reviewer: ���� ����(-�-.-ov�_ Date• �—3� _��� <br /> Reason for Denial: <br />