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- • SEPTIC SYSTEM APPROVAL <br /> O \ �COPY <br /> � � <br /> �%O `� ��;��_� <br /> � �,� <br /> ���� �� � � '������ CITY of ORONO <br /> .� ` �.., A+ <br /> � <br /> �,� �ti j�� Municipal Oftices <br /> "�' , <br /> � '+' � '��' G%� Street Address: Mailing Address: <br /> ��� �� ������,% <br /> X'E$g� 2150 Kelley Parkway P.O. Box 66 <br /> ----- Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �� �✓1c=YZ, �' (�0 �M�?1� Phone (Home) •— (Work) -- <br /> Address 2(�q$ ��=tn 1 u.� (�(�ir� E.�st City�e�� (.�1� State �1'1N Zip $535�6 <br /> Site Evaluator 5- � � sf�n State License #�� Phone# y97 - 35'C�(� <br /> Type of Establishment: Single Family Multi Family <br /> Commercial I�o Garbage Disposal Yes x No <br /> No. Potential Bedrooms (o Est. Gallons Per Day �j OC� <br /> Water Meter Required: Yes No� Soil Sizing Factor , ��3 � Y �� � <br /> Perc Rates P-1 �I�`� P-2�(, P-3:3.� P-4_� P-5 P-6 P- <br /> Restricting Layer Depth B-1 '� B-2�" B-3 �" B-4 �f" B-5 36'` B-6 Z£�'` <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/ Alarm <br /> Septic Tank Size !Z-50 /p0� # of Tanks �- Lift Tank Size /Z 5C� <br /> Pump Brand � Z r�� GPM �2 Head J(o� <br /> Treatment System: <br /> Minimum(�p'x 75')�-�37<I�L�Square Feet with�_inches 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 ��licensed septic contractor prior to installation. <br /> NOTICE TO INSTALLEFiS: 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 /> ACCEPT�D� DEPIIED By the City of Orono subject to existing regulations and <br /> thefollowingconditions: G� �- ��iv��rv� ��r� OF l2'� S��Y�a .�L'�f�i��cl �%P1�iL� �� S�cl�-L� <br /> Faod �-�' R�rl�l.l��� Gb�l w-i � �! wi i�ii v��uu9 5 e��;i -/,�s. <br /> �_. <br /> By: 2� Gt r.� `1-2 -�� <br /> Chris Pence, On-Site Systems Manager <br /> SYSTEM IS DESIGNED FOR <br /> BEDROOMS. ANY INCREASE IN IVUMBER <br /> OF BEpRppMS INYAIIDATES THIS DfSIGN, <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />