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. • e <br /> I will be installing the following: <br /> u��e <br /> Tanks ..�x.�'s+�''� <br /> �'�recast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: � <br /> Size of Tanks: �� <br /> Treatment System <br /> Trenches s.f. � <br /> .-��____. <br /> ��J Mound `��C�� s.f. �f t� � � <br /> Gravel less s.f. <br /> Chamber s.f. <br /> Final Cover/ Top Soil <br /> to be borrowed from site (show location on site plan) <br /> '� trucked in <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 d corr ct. <br /> Signature of Applicant � Date: S`y—� g <br /> MPCA License No.: �-2 �.� <br /> Staff Review: Accept ❑ Denied <br /> Reviewer: ������r�. � Date• S� J �d � <br /> Reason for Denial: <br /> Comments (to be printed on inspection card): <br /> V:\(Permits)\Septic Permit Application-New Perrnit Fees 2009.doc <br /> 2 �2 <br />