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T � <br /> � '' <br /> � ��. x,� ,r � .. ��r s�p ;r m e� ..�§` � �1�� ' �� x �` a� <br /> � �4 s . .g �' .�� 8 � s � � �t�e��3 ����� '73��.: <br /> # <br /> � <br /> "+...� � � ��� �ti.�a � �� .� :��F �s L 5 �, �' � p <br /> ��,'�f�` ��f��l��M�� ���`., # 1 .� <br /> I will be instaliing the following�:! <br /> T s <br /> Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other <br /> (list manufacturer) <br /> Number of Tanks: � <br /> Size of Tanks: �vV � <br /> I <br /> Treatment System �'� <br /> Trenches '' s.f. <br /> � Mound ���� s.f. <br /> Gravel less s.f. <br /> Chamber s.f. <br /> NOTE: The contractor is nequired to provide an As-Built of the system before the <br /> final inspection. <br /> The undersigned hereby applie� to the City of Orono for issuance of a septic system <br /> installation permit, agrees to do all the work in strict accordance with ordinances of the City <br /> and regulations of the State of Minnesota and certifies that all statements made on this <br /> application are complete, true andl correct. <br /> Signature of Applicant Date: S� � � � � <br /> MPCA License No.: �--; �P � <br /> Staff Review: ❑ Accept ❑ Denied <br /> Reviewer: Date: <br /> Reason for Denial: <br /> Comments (to be printed on ins�pection card): <br /> I� 2 /2 <br />