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-r- _ <br /> NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate <br /> boxes. <br /> 0? 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 f'1-e C s >` <br /> Tank Capacities: 1)/IO gal. 2) Osoo gal. 3) /oo d gal. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system design requires 46 gpm at 2.� feet of head. <br /> High water alarm make & model . Outside <br /> electrical work to be completed by installer X electrician <br /> other . Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. X Mound <br /> Depth of rock below pipe " Rock bed dimensions /o <br /> Drop Boxes Sand bed dimensions y / 'x 73 <br /> Distribution Box Pressure Dist. Pipe Diam. <br /> Maniford Pipe Diam. 1 <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> Xtrucked 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 /> Signature ofApplicant% �,'� Date: 7 / g P‘ <br /> MPCA Certification No.: 7 S <br /> Appro al � De 'al <br /> Staff Review: pp <br /> gr <br /> Reviewer: ,%iZtAg Ail � Date: <br /> Reason for Denial: <br />