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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> I have received a copy of the system design including the City of Orono <br /> Septic System Approval Cover Sheet. <br /> D .2. I will be installing the following: �J y� w�`S w <br /> A. Tanks: _Precast Concrete Other Manufacturer pt � <br /> Tank Capacities: 1) !2 s a gal. 2) 123-0 gal. 3) 12 so gal. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system design requires gpm at feet of head. <br /> High water alarm make & model Outside <br /> • ' electrical 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 dimensions 'x ' <br /> Drop Boxes Sand bed dimensions 'x ' <br /> Distribution Box Pressure Dist. Pipe Diam. " <br /> Maniford 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 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 /> A � W /) /. <br /> SignatureofApplicant: Da — 2 <br /> MPCA Certification No.: <br /> Staff Review: Approv Denial <br /> Reviewer: <br /> Date: <br /> Reason for Denial: <br />