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w� � ��v� '��P � � 9 �' �',� �� �r 3 <br /> ��. J - i . ". ��. �8 � � £ .`W aY <br /> Y � & � v s r` . . ." '� ;��w��i's' ..;�4`4 .�.� �,AEi. ; �� t� <br /> ��. `''�,�.�^ �' y! rv:;, f <br /> 1 will be installing the following: <br /> T nk <br /> Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: � <br /> v � 5(� c�-..Lb� 3 �� �, t <br /> Size of Tanks: 1 � <br /> Treatment System <br /> Trenches s.f. <br /> � Mound � 3 � s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> NOTE: The contractor is required to provide an As-Built of the system before the <br /> final inspection. <br /> The undersigned hereby applies to the City of Orono 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 correct. <br /> Signature of Applicant Date: �G^ � � ^ (S� <br /> MPCA License No.: � `� � <br /> Staff Review: �] Accept ❑ Denied <br /> � � �� � �� <br /> Reviewer: Date: <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> 2 / 2 <br />