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4 `� . <br /> ,�k " ' � a �,.. # ; r <br /> $ ^ ym !, £ � 1� '�� .`` 3� ✓ , <br /> f� � - � ..£ ��. ... 2 ✓ � �'^°`yfe'�G �" t� �" <br /> e. - . ., .. , a. � '�' � 4v <br /> ��„� . �� � ,��; � .: � x �rk ��`� � <br /> �;: <br /> ;m �...� � <br /> � ; <br /> . . , . <br /> , . <br /> .. : <br /> � �M <br /> - � , , ..._ . .� <br /> I will be installing the following: <br /> T s <br /> Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufadurer) <br /> Number of Tanks: � <br /> Size of Tanks: 3� � 2�`-� , �� <br /> Treatment System <br /> �� Trenches lU �� s.f. <br /> Mound 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: `� � j� � N <br /> MPCA License No.: t--� �� <br /> Staff Review: Accept ❑ Denied <br /> Reviewer: Date: <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> 2 /2 <br />