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. - 1 0.�,. <br /> � <br /> 0 0 <br /> C ITY of ORONU <br /> ,� , f.�.:. ,� <br /> `�`,, t � . Er ;;' �0��� Municipal Offices <br /> i ti , ; <br /> � �`y . �. �, � <br /> t ' ' ��.� SVeet Address: � Mailing Address: <br /> `4�fEgKO�'- 2150 Kelley Pa�kway ��� P.O. Box 66 <br /> =-_� O r o n o, M N 5 5 3 5 6 Q�� C ry s t a l B a y, M N 5 5 3 2 3-0 0 6 6 <br /> Owner RVC �o,nEs C��cic.� Phone (Home) (Work)3z8-/��. ! <br /> Address �75 Ci�/5��� C✓�P k !�. City Cot2q Cstkc State h4�1 Zip SS356 <br /> Site Evaluator S-�TipS-�I►n State License # 3 qy Phone# �f97-.�566 <br /> Type of Establishment: Single Family ]C Multi Family <br /> Commercial /Jo Garbage Disposal Yes No <br /> No. Potential Bedrooms � Est. Gallons Per Day (9 5('� <br /> Water Meter Required: Yes No�C Soil Sizing Factor , 3 . 5 Z <br /> Perc Rates P-1 z�� P-2 Z•5 P-3� P-4 g_$ P-5 y�� P-6� -7 <br /> Restricting Layer Depth B-11(� B-2 Zp"" B-3 Zp" B-4�' B-5 0" B-6�6 " <br /> Type of Treatment System: <br /> Standard k 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 /> Holdinb Tank W/Alarm <br /> Septic Tank Size /Opp # of Tanl:s � Lift Tank Size /O OC) <br /> Pump Brand GPM �-(O I�ead !2' <br /> Treatment System: <br /> Minimum !0'x SS' �Y3x q'q. Square Feet with�_ inches of rock belo�v pipe <br /> Type of covering abric�_ Other � <br /> THIS IS NOT A PERMIT. This is a design approval form �vhich 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 x DEMED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> By: ' l�� G-zz-oo <br /> 11�iS SYSTEM tS DESiGNED FOR Chris Pence, On-Site Systems Manager <br /> �BEOROOMS. ANY tNCREASE tN Nt1MBER <br /> OF 8EDR001�S tNVAUOAIES TNIS DESJGN. <br /> Telephone(612)249-46W • Fax(612)249-4616 <br />