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` � � SEPTIC SYSTEM APPROVAL <br /> O �� ORONO COPY <br /> � � O <br /> 0 � �, '�c <br /> , j;�,._ ,� �Q CITY of ORONO � <br /> a � <br /> v$,, ; �lGr �;' � Municipal Offices � <br /> `.�. � �d <br /> � , '. G '' O� Street Address: Mailin� Address: ,,.� <br /> ��9�fEgg��� p'� 2150 Kelley Parkway P.O. Box 66 <br /> = Orono, MN 55356 Crystal Bay, MN 55323�0066 <br /> Owner Phone (Home) (Work) <br /> ��;,t �, Address .��l�S L-r�n.2�A��:' Lr.� City ORoao State ��+ Zip <br /> Site Evaluator�,��StW�� State License # `t 3 Phone# ��z- 6 g L-�Sf3 7 <br /> ����C` � Type of Establishment: Single Family�_ Multi Family <br /> Commercial /l�c Garbage Disposal Yes No <br /> No. Potential Bedrooms $ Est. Gallons Per Day 7$v <br /> Water Nleter Required: Yes No� Soil Sizing Factor /� (� �] <br /> Perc Rates P-1 /7�S P-2� P-3 /6,S P-4�--� P-SaN�� P-6� P-7 <br /> Restricting Layer Depth B-1� B-25u" B-3 �c��" B-43b " B-5 y�" B-6 gy'' <br /> Type of Treatment System: <br /> Standard�� Experimental Alternative <br /> Pressurized Mound System At-Grade System <br /> Gravity Trenches System x Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> HoldinQ Tank W/Alarm <br /> Septic Tank Size j 3,��� # of Tanks Z. Lift Tank Size �34� <br /> Pump Brand --- GPM �}� Head � � <br /> Treatment System: —�T— <br /> Minimum 1 2 S�-( Square Feet withlc�'� r�;v� inches of rock below pipe <br /> Type of covering Fabric� 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 DRAI`FIELD AREAS MUST BE FENCED OFF prior to building site excavation and <br /> . fencina 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 isting regulations and <br /> the follow�ina conditions: i <br /> ; <br /> a <br /> �SY'STEM IS dESIGNED FOR By: �1�; �-�,t.c�� <br /> BEDROOMS. ANIf INCRf�►SE IN NUMBER C � ence, On-Site Systems Manager <br /> Of BEDROOb1S INVAUDATES TNIS DESIGN. <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />