Laserfiche WebLink
� <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> �_ 1. I have received a copy of the system design including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> ,� 2. I will be installing the following: <br /> A Tanks: �_Precast Concrete Other Manufacturer P�e Cas�` <br /> ,���g Tank Capacities: 1)/oov gal. 2) gal 3) gal <br /> ���j S <br /> � P r `G k� t B. Pump Station(if required) // <br /> NQ Q� t �1QC Pump make&model �o���s !� (attach pump curve& <br /> �Q � � literature); system design requires�_gpm at � g feet of head. <br /> n� M�i�� � High water alarm make&model /� L-v . Outside <br /> � � '( electrical work to be completed by x installer k electrician other. <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions ' x ' <br /> Drop Boxes Sand bed dimensions ' x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Manifold Pipe Diam. " <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 insta.11ation permit, <br /> agrees to do all work in strict accordance with ordinances of the City and the regulations of the State <br /> of Minnesota,and certifies that all sta.tements made on this application are complete,true and correct. <br /> SignatureofApplica�lE/�a�/wi^-� '�' Date: �^ � � " � 7 <br /> MPCA License No. �l� g . <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> Staff Review: Approval Denial <br /> Reviewer: Date• �� �9 '� / <br /> Reason for Denial: <br />