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� � SEPTIC SYSTEM APPROVAL <br /> 0 0� <br /> � <br /> � � <br /> � .�. � <br /> =�{a; :, r ci�Y�f o�ao�o <br /> ,��::: r�:� �„ ; <br /> � � ��„� �',r .`,; ,��,� Nlunicipal Offices <br /> ,- ,�. � �,, <br /> \�',� ' � ' � :� ;� Stnet Address: hlailing Addrass: <br /> ���Es�p�' 2750 Keiley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address .,� �5a� 1�c�2 ����, �1 ru•; I E: City �t�'���v State �> �,� Zip <br /> Site Evaluator��l E,c�,�vr��n�, State License# b y Phone# u�7- 3�q�; <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms S� Est. Gallons Per Day 7,5� <br /> Water Meter Required: Yes_ No� Soil Sizing Factor . S3 <br /> Perc Rates P-1 3� P-2 �f� P-3 '�� P-4 �!0 P-5 5,3 P-6 y� P-7 <br /> Restricting Layer Depth B-1 ►��'= B-2 Zc" B-3 !8'` B-4 !9" B-� i��` B-6 ?o�� 8-? Z��` Q-F_2Z'' <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 I 500 # of Tanks '� Lift Tank Size S�� <br /> Pump Brand GPM �� Head �-�� <br /> Treatment System: � <br /> Minimum �# f x�5 d- ����C�quare 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 VEHICULAR TRAFFIC OF ANY KIND is allowed within 20'of tested drainfield sites ever. <br /> ACCEPTED /�, DE1�iIED By the City of Orono subject to existing regulations and <br /> the following conditions:S P�s��a l L; ,%�; � h G��o�l�P �'���'� � I 7�' N�'� �"t 2 7"', <br /> r / <br /> By: '� � I <br /> Chris ence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4b16 <br />