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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate <br /> boxes. <br /> 1. I have received a copy of the system design including the City of Orono Septic <br /> System Approval Cover Sheet. <br /> V 2. I will be install' g the following: <br /> A. Tanks: V Precast Concrete Other Manufacturer <br /> Tank Capacities: 1) I$()c. gal. 2) (-5-0c..) gal 3) I S00 gal <br /> B. Pump Station(if required) 07(2 Ft <br /> Pump make&model Gov�5. (attach pump curve& <br /> literature); system design requires 64 2,(i gpm at Zct.1 feet of head. <br /> High water alarm make&model . Outside <br /> electrical work to be completed by installer /electrician other. <br /> C. Treatment System: <br /> Trenches: s.f. Mound <br /> Depth of rock below pipe " Rock bed dimensions 10 ' x 7 ' <br /> Drop Boxes Sand bed dimensionsSZ.2- ' x 1O1.(9' <br /> Distribution Box Pressure Dist. Pipe Diam. I'/Z " <br /> Manifold Pipe Diam. 2,`' " <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 ofa 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 . : : statements de o' is appl' •tion are complete,true and correct. <br /> Signature of Applicant •% _� / Date: ?-(/-00.- <br /> MPCA License No. 703 <br /> Staff Review: Approval Denial <br /> Reviewer: Date: <br /> Reason for Denial: <br />