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67/21/2604 14:01 3202382343 HENTGES PAGE 64/14 <br /> CUSTOMER: <br /> Nam�: 'r"om I�inquist <br /> Sfireet Addresa: <br /> City, State, Zip Code: <br /> Phones; (H) 763-381-04p9 Work 763-541-5303 Cell 612-369-2402 <br /> SiTE ADDRESS: <br /> Street: Sfiubbs Bay Road <br /> Giry OranQR MN 55356 <br /> Tovmship <br /> Plp <br /> Date of design 5-10-04 <br /> System information X New Replacement <br /> '�ype of system � Rock Trench Gra�velless trench <br /> X Maund At-Grade <br /> � Chamber .Alt�rnative, Other, Perform. <br /> Type o#esta�blishment Single Family Home <br /> Septic tank inform�tion No. & size af usable existing tanks: <br /> No. & size of new septic tanks: (1)-1250� �1 -1000 <br /> "'"` Is there a grinder/ejector pump used in th� system? NO <br /> (CheGc f�additional sizing requirements and com�rtmentaiizatio�wlth LUG) <br /> Pump tank information Size of pump tank 1250 gallons <br /> Site considerations � Propane or natural gas lines in way7 <br /> Under ground electric lines in way? <br /> Cable or phorte lines in way? <br /> Buried water lines in way? <br /> � Existing septic tank ta pump and inspect? <br /> Old septic t�nks ta pump and bury? <br /> Septic tank truck access available? <br /> X Trees to be removed? <br /> Di�cult tank & dr�infield equipment access/workability7 <br /> Other: <br /> Variance required? NO pescribe: <br /> PAG� 2 OF 12 <br />