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�► <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate ' <br /> boxes. <br /> �1. I have received a co of the s stem desi n includin the Ci of Oron <br /> PY y g g ty o Septic <br /> System Approval Cover Sheet. � <br /> �� 2. I will be installi the following: �,� <br /> �� <br /> A. Tanks: Precast Concrete Other Manufacturer �1���-. <br /> Tank Capacities: 1) /'��v gal. 2) /�� gal 3) �al <br /> B. Pump Station(if requued) <br /> Pump make& model �y�L��2- �/✓�� (attach pump curve& <br /> literature); system design requires�gpm at����feet of head. <br /> High water alarm make& model 'j��� � � . Outside <br /> electrical workto be completed by�installer electrician other. <br /> C. Treatment System: / <br /> Trenches: s.f. V Mound <br /> Depth of rock below pipe " Rock bed dimensions �D ' x�' <br /> Drop Boxes Sand bed dimensions �' x� <br /> Distribution Box Pressure Dist. Pipe Diam. /`�� " <br /> Manifold Pipe Diam. r,2 " " <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 th�t all statements made on this application are complete,true and correct. <br /> SignatureofApplicant � " - C _.Pj�vL� Date: ���� (i <br /> NIPCA License No. . ��� <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staff Revie�v: Approval Denial <br /> Reviewer: _ �! � �� ��r��rn-c,,� Date: � �—y —� � � <br /> Reason for Denial: <br />