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' � , SEPTIC SYSTEM APPROVAL <br /> , <br /> �� �.�� � II�s�EcmoR�s Co�r � <br /> � <br /> � � \� <br /> , T�,.. ,� C ITY of ORONO <br /> � �!C► Municipal Offices <br /> '�� ` ,t '- . G <br /> Street Address: MailinQ Ad�ress: <br /> ���`��C'EggO�'�� � 2750 Kelley Parkway P.O. Boz 66 <br /> __-- Orono, MN 55356 Crystal Bay, MN 55323•0066 <br /> Owner r1�S � Vrt 0 Phone (Home) (Work) <br /> Address 25 N s q City rYlaple Pl�n;n� State 71�.1 ZipS�� <br /> Site Evaluator5-�' �S-�ir,c, State License # ��qy Phone# y��- ��� 1! <br /> Type of Establishment: Single Family� Multi Family <br /> Commercial n,�� Garbage Disposal Yes No <br /> No. Potential Bedrooms � Est. Gallons Per Day �-/SU <br /> Water Meter Required: Yes No� Soil Sizing Factar . � <br /> Perc Rates P-1�$..S P-2� P-3 S, P-4 P-5 P- P-7 <br /> Restricting Layer Depth B-1� B-2q2,� B-3 ,��}"` 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 I ODC� # of Tanks � Lift Tank Size� <br /> Pump Brand — GPM ��j Head j �� <br /> Treatment System: <br /> Minimum (10 zWl')t�y�x�Z�� 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 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 MUST BE FENCED OFF prior to building site exca�-ation 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 /> thefollowingconditions: Vaniv+ntf: �an�Fd � Q /0� �Rc?� l�e�� rU `� /ine. E��isfi►? <br /> kS ust b� d ,��tf z 7�'�D�Oi� Sc 2" uvt er' Sl0 N� � o �k� <br /> By: -?-oc► <br /> Chris Pence, On-Site Systems Manager <br /> ����� <br /> ,�s. �nnra�a��t� c�2�'65 ��- _ / -- <br /> oF�IS�i1tAL�A�Es�s�S1C�+t. � /`� � (`�Ss� <br /> � <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br /> ��g� ��s��� <br />