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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:3 Precast Concrete _ Other Manufacturer <br /> Tank Capacities: 1) /DOD gal. 2) (600 gal. 3) As co gal. <br /> B. Pump Station (if required) <br /> Pump make & model / 8 S (attach pump curve & <br /> literature); system design requires gpm at 01,5 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. I/ Mound _ <br /> Depth of rock below pipe " Rock bed dimensions /O 'xSS ' <br /> Drop Boxes Sand bed dimensions c{/ 'x S'L' <br /> Distribution Box Pressure Dist. Pipe Diam. 7T" <br /> Maniford Pipe Diam. ..2" <br /> D. Final Cover/Topsoil to be: 7S borrowed from site <br /> (show location on site plan) <br /> 2 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 /> SignatureofApplicantL� Date: f‘ <br /> MPCA Certification No.: 7‘ <br /> Staff Review: Approv. , Denial <br /> Reviewer: ''7, I Date: :?,- /1'� <br /> Reason for Denial: <br />