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� �` � SEPTIC SYSTEM APPROVAL <br /> 0 a���a�o�rsaopv <br /> � � <br /> 0 0 <br /> � <br /> > ..f,. ,� CITY of ORONO <br /> !4 Municipal Offices <br /> ��t � � :�G~ Street Address: Mailing Address: <br /> `�kEggO�'�-�� 2150 Kelley Parkway P.O. Box 66 <br /> --= Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �,���ec�S �%rc�L1 �'.1�� Phone (Home) (Work) <br /> Address /E'�> Crz�S-�i�/ CiZc('�K City C`,r?�t�l�` State ���� Zip <br /> Site Evaluator S--r� �"t'�t���� State License# .����/ Phone# ���i]- :�.5 �,E� <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial l�`� Garbage Disposal Yes No <br /> No. Potential Bedrooms .S Est. Gallons Per Day J5(� <br /> Water Meter Required: Yes No�- Soil Sizing Factor . �3 (, z Y5��d'%��f 1� <br /> Perc Rates P-1 y�7 P-2 G.2 P-3 `�: 7 P-4 �`..3 P-5 �� P-6:�?,� P-�7 <br /> Restricting Layer Depth B-1.�?�s`' B-2,��`' g-3 ?z'" B-4 ll" B-512�' B-6 �" <br /> Type of Treatment System: <br /> Standard � 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 ,,�5'';; !Ce'� # of Tanks Z- Lift Tank Size�:,?5�% <br /> Pump Brand -- GPM H ] Head /� <br /> Treatment System: � <br /> Minimum(iu'x;;��.)r�.3'�'�`%v� Square Feet with / inches of rock belo�i-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 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 ���ill 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 X DENIED By the City of Orono su 'ect- existing regulations and <br /> thefollowingconditions: �:��� �:��,�,��� �r �-� �', �ri�tfl�� l�%,f � � '` <br /> 6 <br /> 1 : � <br /> By: �Hk� -C��z�'c� ��_ :,_ �. <br /> C is Pence, On-Site Systems i�lanager <br /> ��I�D�� _ <br /> �p�ppt�S, ANr a�CREASE IN NUMBER <br /> ��QI�WVAUDAT�INIS OF�SlGN. �,_ <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />