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i. � <br /> SEPTIC SYSTEM APPROVAL <br /> O _: ���4(�(}P� ORONO COPY �,�0 <br /> � � � <br /> O � t7 <br /> .� <br /> , f,�,.. ,� CITY of URONO `��� <br /> �� �'_ ; �j�'ti Municipal Offices <br /> ,� � � ,. Street Address: Mailing Address: <br /> � �'q$'ESKpg'=,-�� 2750 Keiley Parkway P.O. Box 66 <br /> ��__--=� Orono, MN 55356 Crystal Bay, MN 55323�0066 <br /> OwnerCN�}RLES CA�¢d�e/I U�O Phone (Home) (Work) <br /> Address 23?��-' /�e V i rJ �.�v��._ ____ City (,vr L.�k� State �✓1,� Zip 553 5� <br /> Site Evaluatorp�ob o(I(�nah-{�State License #�_ Phone# Y79- /5 y7 <br /> Type of Establishment: Single Family � Multi Family <br /> Commercial �o Garbage Disposal Yes�� No <br /> No. Potential Bedrooms $ Est. Gallons Per Day 7 S� <br /> Water Meter Required: Yes No� Soil Sizing Factor • '83 • 6 f 2 <br /> Perc Rates P-1� P-2 !0,q P-3 P-4 P-5 P-6 P- <br /> Restricting Layer Depth B-1 25" B-2 2B` B-3 3c�" B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard x 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 /> Holdin� Tank W/Alarm <br /> ext3.�'"! <br /> Septic Tank Size Z-lor�o r IOGb # of Tanks Lift Tank Size 150� <br /> Pump Brand — GPM 5 1 , Head 3 0. �/ � <br /> Treatment System: <br /> Minimum (!o f b ' i 39 z f39� Square Feet with_�inches of rock below pipe <br /> Type of covering Fabric X 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 NIUST BE FENCED OFF prior to buildin� site excavation and <br /> fencin� must remain in place until final site grading. Approval to pour footin�s will not be granted <br /> until the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VEHICULAR T12AFFIC OF ANY KIND is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED �C DENIED By the City of Orono subject to existing regulations and <br /> thefollo�vin�conditions: ( x�sfin,4 Wel� rr2usf �- �b��d�� A�ior � Mocch <br /> sfRu�-��o . —x� s '�ks a c� ✓ � �-�` n> <br /> - t <br /> By: -23-0 0 <br /> Chris Pence, On-Site Systems Manager <br /> TI��!SYSTEM IS DESIGNED FOR <br /> 6EDROOMS. ANY INt�tEASE IN NUMBER <br /> OF BEDROOMS INYAUO�AIES THIS OESIGN. <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />