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` SEPTIC SYSTEM APPROVAL <br /> . ���� ���� ORONO COP�Y <br /> � � � <br /> � <br /> O O ��, � O <br /> ,� <br /> ���� ��� - �,1.�.� �_ �, ��; ���� CITY of ORONO o <br /> .�,� �; �_�' �j�'E�r�/ � MunicipalOffices (� <br /> .�� ' ��'�'4� � Street Address: Mailing Address: � <br /> , _jfEg_�� 2750 Kelley Parkway P.0 Box 66 <br /> ' Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> ��� � Address Z I�i'6 ('y�vz2(v��e� <br /> L;,3 City A�wNa State v'ia Zip <br /> ��jl oc�= � Site Evaluator �'c5���',,�A State License # y3 Phone# ��Z–��3 2– �S�c�7 <br /> ' Type of Establishment: Single Family�_ Multi Family <br /> Commercial �1c Garbage Disposal Yes No <br /> No. Potential Bedrooms 5 Est. Gallons Per Day 7Sc.� <br /> `Vater Meter Required: Yes_ No� Soil Sizing Factor /;b "7 <br /> Perc Rates P-1 1G P-2 !2 P-3 12 P-4 i3 P-5 iy P-6 �� P-7 <br /> Restricting Layer Depth B-1 �" B-2 y" B-352" B-4�D" B-560" B-6 S�" , 5��� 6�?%5`'�� EC <br /> Type of Treatment System: <br /> Standard� Experimental Alternative <br /> Pressurized Mound System 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 �3� # of Tanks � Lift Tank Size � <br /> Pump Brand �— GPM - Head <br /> Treatment System: ,� <br /> Llinimum ►'� Square Feet with �� C',�:„,���' ches 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 appro�-al 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 �anted <br /> until the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KI�'D is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED � DEIVIED By the City of Orono subject to existing regulations and <br /> the follo�r-ina conditions: <br /> .. � <br /> r <br /> , � . <br /> By: ��� L�� . <br /> ��1$DESIGNED FOR Chn ence, On-Site Systems Manager <br /> _�S. ANY INCRE�sE i�� r�uMe�R <br /> OF B��AUQATES TNIS DESIGN. <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />