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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check aIl appropriate <br /> e� 1. I have received a copy of the system desijn including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> '�/ �` 2. I will be installin�the follo�vin�: U S-e -eu���-�'' <br /> � <br /> A. Tanks: Precast Concrete Other Manufacturer <br /> P�_ } � � � ._ � <br /> Tank Ca a ties;.. .1. �___�rl------2�����1~,—.._---�--�-C��.. QaI <br /> B. Pump Station (if required) <br /> Pump make&model ���-e �� ���� (attach pump curve& <br /> literature); system desi�n requires ��gpm at 3Z feet of head. <br /> High water alarm make &model C.,e�c(�-�,v. . Outside <br /> electrical work to be completed by �� installer electrician other. <br /> G�n� C�/r-�t k�t y � -e,c<<r4� P�.,�,�� 5 f�.f�u,� <br /> r <br /> C. Treatment System: <br /> Trenches: s.f. �� Mound <br /> Depth of rock below pipe " Rock bed dimensions /b ' x � ' <br /> Drop Boxes Sand bed dimensions�_' Y 35,�' <br /> Distribution Box Pressure Dist. Pipe Diam. j iL " <br /> Manifold Pipe Diam. -L. " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> r�(.�how 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 /> ajrees to do all work in strict accordance with ordinances of the City and the rejulations of the State <br /> of Nlinnesota,and certifies that all statements made on this application are complete,true and correct, <br /> SignatureofApplicant - Date: �-^ / � �� <br /> NIl'CA License No. � 1 � <br /> -------------------------------------------------------------------------------------------------------------------------- <br /> Staf�'lZevaew: App�-oval Denia� <br /> �eviewer: <br /> ��✓`� D�te: �' � � �"� 'd � <br /> Reasoa� f�r I➢ena�fl: <br />