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` SEPTIC SYSTEM APPROVAL <br /> . �. . <br /> � <br /> 'g" �� �0�� ���� °�«""� <br /> O �« <br /> � � <br /> i� -;;,,;',t,;�;_ �i��� �� ����� <br /> �, a -�, �I� <br /> ',�� .�- G�ti/ MunicipalOffices <br /> ��;�, � � ���'' �� � SVeet Address: Mailino Address: <br /> ��'� � � ������•c�,'�;�i� , <br /> �'��y$���► 2750 Kelley Par�cway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address �(?SS ,BR-�lDE Rd City pizo,U� State M� Zip <br /> Site Evaluator 5—P %� � State License#39� 627 Phone# Y 9�- 356.6 <br /> Type of Establishment: Single Family_� Multi Family <br /> Commercial �1 o Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 7$a <br /> Water Meter Required: Yes No k Soil Sizing Factor , 83 (, �(S q�(/{�F J <br /> Perc Rates P-1 Z�7 P-2 2.� P-3 2•7 P-4 3.1 P-5 Z,� P-6 �,K P 7 <br /> Restricting Layer Depth B-13y" B-2��� B-3 26'� B-4 l8" B-5Z6" B-6 20" <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/Alann __ <br /> Septic Tank Size j2 50 00� # of Tanks Z Lift Tank Size�ZSc� <br /> Pump Brand GPM ,�q Head /y' <br /> Treatment Syst m: <br /> Minimurr�d,�b � Zo��oZ' Square Feet with_�_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 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 prunary and alternate sites are protected. <br /> NO VEHICUI.AR TRAFFIC OF ANY KIND is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED X DEl�TIED By the City of Orono subject to e�cisting regulations and <br /> the following conditions: <br /> By: � <br /> Chris Pence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />