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. . SEPTIC SYSTEM APPROVAL <br /> , - _� �\. <br /> �� �� ORONO Cpp'X <br /> �� � � f?Rt�NO�.''CiP'�' <br /> "�� ��� <br /> � ��� ��� '��'����� CITY of ORONO <br /> � �,,: r�... �, ; <br /> �`„ � ' `;�. ����� �!�►��� Municipal Ot�ices <br /> �.,; ,�, . � �/ <br /> ��.t ' � ,��e� � - Street Add�ess: Ma11inQ Address: <br /> �`9$'Egg04' 2750 Kelley Pa�kway P.O. Bax 66 <br /> ��--- Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner e �R�US Phone (Home) (Work) <br /> Address SS E�'R i2 � City (� k� State rJ Zip S�'.35� <br /> Site Evaluator�-(�,4�y's c�, . State License# 32� Phone#�(o/2 y�{g—217 6 <br /> Type of Establishment: Single Family_� Multi Family <br /> Commercial J�h Garbage Disposal Yes No <br /> No. Potential Bedrooms 5 Est. Gallons Per Day `? � <br /> Water Meter Required: Yes No� Soil Sizing Factor ,(�D �z <br /> perc Rates P-1 �8 P-2 'Lo P-3 28 P-4,32 P-�Z� P-6_� P-7 LG <br /> Restricting Layer Depth B-1 lu" B-2 l9'� B-3 QS`� B-4 Z6`` B-5 S`� B-6 �" <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 l25D #of Tanks Lift Tank Size��Q <br /> Pump Brand GPM Zy Head `� <br /> Treatment System: � <br /> Minimum (idx 62`�d-�.S�1x8�� Square Feet with_�inches of rock below pipe <br /> Type of coveri g 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. Appro��al to pour footings will not be granted <br /> until the Inspections Department has verified the primary and altemate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KIND is allowed�iithin 20' of tested drainfield sites ever. <br /> ACCEPTED� DEIVIED By the City of Orono sub�ject to existing regulations and <br /> the following conditions: �n1 S ;� � (,t.viCCP/� �R� <br /> � <br /> By: -b-oo <br /> Chns Pence, On-Site Systems Manager <br /> �SYSTEM fS DESIGNED f� <br /> BEDROOMS. ANY INCREASE IN NUMBER <br /> Of BEDROOMS INYALIOATES TNIS OESIGM. <br /> Telephone(612)249-4600 • Fax(612)249�616 <br />