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HomeMy WebLinkAbout1994-09-20 Application for Septic System PermitNOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate boxes. I have received a copy of the system design inchMing the City of Orono Septic System Approval Cover Sheet. 2. I will be installing the following: A. Tanks: � Precast Concrete _Other Manufacturer -r-1- \ 0 -QV -Qt Tank Capacities: 1) Sa gal. 2) &!22 gal. 3) - .—S�al. B. Pump Station (if requireid Pump make & model Zoe 04— (attach pump curve & literature); system design requires A(—)__ gpm at l2 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. Depth of rock below pipe Drop Boxes Distribution Box 4- Mound Rock bed dimensions LO 'x&S Sand bed dimensions I't 'x�' Pressure Dist. Pipe Diam. 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 statemf 's made on this application are complete, true SignatureofAppli Date:" --I — u MPCA Certification No.: ( LC") Staff Review: Approv Denial s� Reviewer: Date- Reason ateReason for Denial: