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SEPTIC SYSTEM APPROVAL <br />, ON <br />CITY Of ORONO <br />tiMunicipal Offices <br />Street Address: Mailin; Address: <br />�314 2750 Kelley Park -Nay P.O. Box 66 <br />Orono, MN 55356 Crystal Bay, MN 55323.0066 <br />0wner_� &k6ERp�'J Phone (Home) y73-1399 (Work) <br />Address l98D 6 7'A A City G,eoay State in l Zip <br />Site Evaluator 5-P i�s�f�� State License # 617 ,�q Phone# yq7- Go�� <br />Type of Establishment: Single Family_(_ Multi Family <br />Commercial /Jo Garbage Disposal Yes No_ <br />No. Potential Bedrooms_ ,� Est. Gallons Per Day 'y5z) <br />Water Meter Required: Yes No }C Soil Sizing Factor <br />Perc Rates P-1 ((, P-22� P-if, 7 P-4 P-5 P-6 <br />Restricting Layer Depth B-1gd" 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 /t3oo # of Tanks 2 Lift Tank Size /ooZ) <br />Pump Brand 3 / Head Z/ <br />Treatment System: GPM <br />Minimum [yirK 16 7/') Square Feet with inches of rock below pipe <br />Type of covering Fabric k 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 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 %X1 DENIED By the City of Orono subject to existing regulations and <br />the follo following conditions: C-,y"L n,7 �Zirrks �rt <br />ich6t /)'< , ykfW&0 f 0," A) � y_ , _. _ � _- <br />bQ NO-{ CO.q �-elt�irl�. BY*5� �ifitD ���% <br />C ence, On -Site Systems Manager <br />Telephone (612) 2494600 - Fax (612) 2494616 <br />