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� � 2 2 g7 �� SEPTIC SYSTEM APPROVAL <br /> � O �xs�Ecrox•s aor� <br /> � � <br /> O O , <br /> � :, �:�1-,;. ,� CITY of ORONO <br /> � � �r�`,, �� �ti ,� Municipal Offices <br /> � , � G Street Address: Mailing Address: <br /> '�� ;¢'� i: <br /> �_ kES�IO_,���� 2750 Kelley Parkway P.O. Box 66 <br /> _--= Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner >C n'tf ,�,a <<�, �'�Ck'��w�r�n; Phone (Home) (Work) <br /> Address ..�(��'$ l"�r�-��r�r-� 'l�d�• City�(;�;>�.�i1�; State l��1N Zip <br /> Site Evaluator �;�--r' � i�•,;�,���� State License # ��� Phone# y�� ) -� ,�.S 6-6 <br /> Type of Establishment: ` Single Family >� Multi Family <br /> Commercial /�'�: Garbage Disposal Yes No <br /> No. Potential Bedrooms �( Est. Gallons Per Day :f:rc; <br /> Water Meter Required: Yes No� Soil Sizing Factor , ?.=' -(z <br /> Perc Rates P-1 %2:� P-2�. j P-3 jS:L� P-4 P-5 P-6 � - <br /> Restricting Layer Depth B-1 �Z., B-2 ZH'` B-31'��� B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard_� Experimental Alternative <br /> Pressurized Mound System x At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size j c�cc; # of Tanks � Lift Tank Size I C�c` � <br /> Pump Brand -- GPM `�O Head �'c:% � <br /> Treatment System: <br /> Minimum('i���5-5"'�r� �t+�xs�� Square Feet with �� inches of rock below pipe <br /> Type of covering Fabric_� Other <br /> THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. <br /> A permit must be issued to a licensed septic contractar priar to installation. <br /> NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the <br /> inspector (249-4600) Call far inspection 24 hours in advance. <br /> ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and <br /> . fencing must remain in place until final site grading. Approval to pour footings will not be granted <br /> until the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED_� DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: � � "r u- ,i� '�r: 'E � �:' ���,� ; 'j � � %L"` i <br /> 'tZ.. ta ��ff-l��2 <br /> e <br /> By: �� �% -i�'--v�> <br /> ����� Chris Pence, On-Site Systems Manager <br /> BEBROONIS. ANY INCREAS'�tN NUMBER <br /> ��VAUO�ATE�THIS QESiG1Y. <br /> Tetephone(612)249-4600 • Fax(612)249-4616 <br />