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. - � <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> 1. I have received a copy of the system design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> � 2. I will be installing the following: <br /> A. Tanks: �c Precast Concrete _ Other Manufacturer j�� <br /> Tank Capacities: 1) � gal. 2) /Soo gal. 3) gal. <br /> B. Pump Station (if required) <br /> Pump make & model G�,Io�s �I�F_ib/Z►f (attach pump curve & <br /> literature); system design requires � gpm at 3 7 feet of head. <br /> High water alarm make & model ���,� �;�,��.C;� Outside <br /> electrical work to be completed by installer _�c electrician <br /> other . Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: �{�j'�q�e <br /> Trenches: s.f. A� <br /> Depth of rock below pipe " Rock bed dimensions � 'x//3 '—Z <br /> Drop Boxes Sand bed dimensions 'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. �_" <br /> Maniford Pipe Diam. Z ° <br /> D. Final Cover/Topsoil to be: bonowed 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 <br /> permit, agrees 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 /> SignatureofApplicant: Date: �'Z-�a <br /> MPCA Certification No.: t ZD <br /> Staff Review: App oval Denial <br /> r <br /> Reviewer: Date: ��?-� <br /> Reason for Denial: <br />