HomeMy WebLinkAbout1994-08-29 Application for Septic System Permit Pg2NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate
boxes.
1. I have received a copy of the system design including the City of Orono
Septic System Approval Cover Sheet.
2. 1 will be installit3B the following:
A. Tanks: !/ Precast Concrete _ Other Manufacturer
Tank Capacities: 1) /&Iy gal. 2) ,cpou gal. 3) / 0ey gal.
B. Pump Station (if required) WEoSN &a 4yoc
Pump make & model 4> r0 31/ "14 IA (attach pump curve &
literature); system design requires �_ gpm at a?,dl feet of head.
High water alarm make & model Outside
electrical work to be completed by installer ,—electrician
other Inside electrical work must be completed by
electrician.
C. Treatment System:
Trenches: s. f. Mound
Depth of rock below pipe Rock bed dimensions /0 'x�'
Drop Boxes Sand bed dimensions j S 'x 7,0 'Ate•
Distribution Box Pressure Dist. Pipe Diam. Pa.
Maniford Pipe Diam. _ 2-
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan)
*'trucked in
The undersigned hereby applies to the City of Orono for issuance of a septic system installation
permit, agrees to do all work in strict accordance with the ordinances of the City and the
regulations of the State of Minnesota, and certifies that all statements made on this application
are complete, true andcegt. /? _ Z-11
Signature of Applicant. X Date: g' '21-f r-/
MPCA Certification No.:_�n-
Staff Review: Approval _ 7`- Denial
Reviewer: Date:
Reason for Denial: