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r <br /> - <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: . Precast Concrete Other Manufacturer f A-eC4_S <br /> Tank Capacities: 1) /ozpo gal. 2)/6 oe gal. 3) leo() gal. <br /> B. Pump Station (if required) <br /> Pump make & model R,81.5- 41 (attach pump curve & <br /> literature); system design requires6 gpm at °Z/' feet of head. <br /> High water alarm make & model f? fd -s' . 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 /D ,x �/3' <br /> Drop Boxes Sand bed dimensions q' <br /> Distribution Box Pressure Dist. Pipe Diam. Q <br /> Maniford Pipe Diam. <br /> D. Final Cover/Topsoil to be: �orrowed from site <br /> (sew 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 /> SignatureofApplicaneA4 s Date: <br /> MPCA Certification No.: 7 <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />