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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> bo s. <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 Manufacture(D4/44vi"v <br /> Tank Capacities: 1) 1300 gal. 2) 1300 gal 3) 1300 gal <br /> B. Pump Station (if required) <br /> Pump make&model2oe1(iv 8 NI 40 (attach pump curve& <br /> literature); system design requires '{'7 gpm at LT" feet of head. <br /> High water alarm make &model 5%1-, il.L. . Outside <br /> electrical work to be completed by installer —lectrician other. <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions/ o ' x 6 ' <br /> Drop Boxes Sand bed dimensions 85- ' x 38 ' <br /> Distribution Box Pressure Dist. Pipe Diam. /1/2, <br /> Manifold Pipe Diam. 2 " <br /> D. Final Cover/Topsoil to be: .. .lorrowed 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 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 statemen made on this application are complete,true and correct. <br /> Signature of Applicant11i-es Date: 7 —/9-0 6 <br /> MPCA License No. (9 4_O <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />