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�� , <br /> SEPTIC SYSTEM APPROVAL <br /> oRo�o c <br /> o ��� <br /> � � <br /> o , o <br /> -:�� � '� CI'�Y of OR011To <br /> � <br /> � ��; t��:t � <br /> \ • , � ' ,� , '�ti Municipal Offices <br /> i, <br /> _ � <br /> StrEet Addrass: Mailing Address: <br /> \`��`��� ,Hp�'�G 2750 Kelley Parkway P.O. Box 66 <br /> S <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner j�q� �E�°GEkO� Phone (Home) Y73—/399 (Work) <br /> Address !q8D 6� �9✓'� City O,�oa v State l.t1,J Zip <br /> Site Evaluator 5-P Tesf�:�� State License# �7 .�9 Phone# �97- So<< <br /> Type of Establishment: Single Family�,_ Multi Family <br /> Commercial /Jo Garbage Disposal Yes No <br /> No. Potential Bedrooms 3 _ Est. Gallons Per Day YSc7 <br /> Water Meter Required: Yes_ No �C Soil Sizing Factor . 8 y Z <br /> Perc Rates P-1 C(, P-22� P-3��7 P-4 P-5 P-6 P- <br /> Restricting Layer Depth B-1 �10" B-2 Yb" B-3 36`� B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard X Experimental Alternative <br /> Pressurized Mound System �C 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 I nOo #of Tanks 2 Lift Tank Size 100� <br /> Pump Brand GPM 3! Head 2� <br /> Treatment System: <br /> Minimum�yI x lo',��r('�'f 71'� Square Feet with inches of rock below pipe <br /> Type of covering Fabric �C. Other <br /> THIS IS NOT A PERIVIIT. This is a design approval form which must accompany the site plan. <br /> A permit must be issued to a licensed septic contractor prior to installation. <br /> NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the <br /> inspector (249-4600) Call for inspection 24 hours in advance. <br /> ALL DRAINFIELD AREAS l��iTST 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 aze protected. <br /> NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20'of tested drainfield sites ever. <br /> ACCEPTED � DElvIED By the City of Orono subject to existing regulations and . <br /> the following conditions: Ex� �N �cs st �K knr e,� f O�cn1 � r hs �r�a . <br /> F e o S tl .s v'� ace . <br /> bK Nof GOA�en�i'l�. By� , <br /> C ' ence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />