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vas <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 /> x 2. I will be installing the following: <br /> A. Tanks: x Precast Concrete Other Manufacturer <br /> Tank Capacities: 1)" 0 0 0 gal. 2) gal. 3) gal. <br /> B. Pump Station (if required) <br /> Pump make & model (attach pump curve & <br /> literature); system design requires 40 tpomr at 24.6 feet of head. <br /> High water alarm make & model Outside <br /> electrical work to be completed by installer electrician x <br /> other . Inside electrical work must be completed by <br /> electrician. <br /> C. Treatment System: <br /> Trenches: s.f. _2i_ Mound <br /> Depth of rock below pipe " Rock bed dimensions 10 'X 50 <br /> Drop Boxes Sand bed dimensiong0 i 1 "D <br /> Distribution Box Pressure Dist. Pipe'iam. <br /> / <br /> Maniford Pipe Diam. 2 " <br /> D. Final Cover/Topsoil to be: borrowed from site <br /> (show location on site plan) <br /> x 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 /> p <br /> /A1, se t8aC <br /> SignatureofApplicant: ��r i' s ate: <br /> 00813 / <br /> MPCA Certification No. <br /> Staff Review: Approval Denial <br /> Reviewer: A' "� ,l2 Date: <br /> Reason for Denial: <br />