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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> r <br /> 1. I have received a copy of the system design including the City of Orono Septic <br /> � - System Approval Cover Sheet. <br /> 2. I will be installing the following: <br /> A Tanks: �Precast Concrete ; Other Manufacturer <br /> Tank Capacities: 1) �So� �al. 2)m..l�`=�gal 3)/ �S� � <br /> ��!ar"r�n'� _ Pu�Clinn. .ef , <br /> B. Pump Station(if required) <br /> Pump make&model �o--��'. � ��'- (attach pump curve& <br /> literature); system design requires G.� gpm at !$. feet of head. <br /> High water alarm make&model s���� r . Outside <br /> electrical work to be completed by insta.11er�electrician other. <br /> C. Treatment System: <br /> �Trenches:/�4- s.f. Mound <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. 2" �� <br /> D. Final Cover/Topsoil to be: bonowed 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 /> agrees 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 statements made on this application are complete,true and correct. <br /> Signature of Applicant�--���'�`�-��—�� Date: � ��'2'�3_ <br /> MPCA License No. �.��. <br /> ----------------------------------------------------------------------=-------------------------------------------------- <br /> Staff Review: Approval Deniai <br /> Reviewer: Date• <br /> Reason for Denial: <br />