HomeMy WebLinkAbout1994-08-17 Application for Septic PermitNOTE: 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. I will be installing the following:
A. Tanks: 3 Precast Concrete _ Other Manufacturer pry c a,% 7 Sys7�
Tank Capacities: 1)16_ gal. 2) /0o- gal. 3) JJ& gal.
B. Pump Station (if required)
Pump make & model M Y v"s /W (attach pump curve &
literature); system design requires 3jD gpm at _1ff ' feet of head.
High water alarm make & model .&V . Outside
electrical work to be completed by installer electrician
other Inside electrical work must be completed by
electrician.
C. Treatment System:
Trenches: s.f.
Depth of rock below pipe "
Drop Boxes
Distribution Box
Mound
Rock bed dimensions -Le—'x
Sand bed dimensions'
'x
Pressure Dist. Pipe D'_"
Maniford Pipe Diam. A,"
D. Final Cover/Topsoil to be: l- 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 and correct. '.qt� 'r L"
SignatureofApplicant: J� l rS�W P 1,^Zw
Date:
MPCA Certification No.: /0'2 a
Staff Review: A oval Denial
S PPr
Reviewer: Date -D27*
2Z*
Reason for Denial: