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- � <br /> NOTE: Applicant rriust initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. � <br /> � � 1. I have received a copy of the system design includin� the Ciry of Orono <br /> Septic System Approval Cover Sheet. <br /> 2. I wiIl be installin� the followin�: <br /> A. Tanks: �. Precast Concrete � Other Manufacturer��ll� �'���'t � <br /> Tank Capacities: 1) fz�� �al. 2) /� <�-c:�a1. ;)/Z��� ba1. <br /> �_z,'�i-� <br /> G,h�� ��, �;Z' <br /> B. Pump Station (if required) <br /> Pump make & model R., ��f � iti��. ��� q l c� (attach pump curve & <br /> literature); system desi�n requires gpm at feet of head. <br /> Hi�h wa[er alarm make & model ,� ;����_� �����: ,� Outside <br /> � ' eIectrical work to be completed by installer _� electrician <br /> other Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. � Mound ��, !� � <br /> Depth of rock below pipe Rock bed dimensions1�'xj� ' <br /> Drop Boxes ' Sand bed dimensions S'? 'x 7.�' <br /> Distribution Box Pressure Dist. Pipe Diam. � `l� " <br /> Maniford Pipe Diam. •� " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> X (show location on site pla�) <br /> trucked in <br /> The undersijned hereby applies to the City of Orono for issuance of a septic system installation <br /> permit, a�rees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this application <br /> are complete, true and correct. <br /> , <br /> Si�natureofAppIicant: ,� ��c�� � � <br /> �- � � Date: ,/�% -- iZ - y' � <br /> , �� � <br /> MPCA Certification No.: <br /> Staff Review: Approval Deni <br /> � Reviewer: /�---��9� <br /> Date: � � <br /> Reason for Denial: <br />