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. . SEPTIC SYS., , APPROVAL <br /> j�__-� � �'•"`�,`� �, <br /> i � O� �� <br /> \\ <br /> �o .: o �,� . <br /> ' _ ;� C ITY of OROl�� <br /> � f <br /> ,lr� .r � , <br /> r�l i <br /> ' �r+�`, � !�,�� Municipal Offices <br /> \���'� �' G~� Str�at Address: Aiail9ns Address: <br /> ��`��E��p��%�'� 2750 Kelley Parkway P.O. Box 66 <br /> ���� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �'�j���};l/�/� �-��}�i�!'�lti Phone (Home) (Work) <br /> Address �?��7�j ��,�v°��w' �,,,' City CJ��°���> State 't�1.L Zip <br /> Site Evaluatar5-�=�;F'S�l�,r«r State License #.."-�_ `i� Phone# ��7�- �"SC: � <br /> Type of Establishmen�Single Family Multi Family <br /> Commercial /�;�� Garbage Disposal Yes No <br /> No. Potential Bedrooms `-� Est. Gallons Per Day (�L� <br /> Water Meter Required: Yes_ No� Soil Sizing Factor e f�; ., YS' 2 <br /> Perc Rates P-1 ���.5 P-2�T( P-3 �(�6 P-4 P-5 P-6 -7 'I <br /> Restricting Layer Depth B-lo?� B-2 ZZ" B-3.j���" B-4 6Z" B-5 �5-v" B-6 yZ" j <br /> Type of T`re/atment System: �, <br /> Standard X- Experimental Alternative <br /> Pressurized Mound System _� At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> Holding Tank W/Alann <br /> Septic Tank Size �� # of Tanks 2- Lift Tank Size(C ` �; <br /> Pump Brand GPM �F'� Head ��Z ` <br /> Treatment System: c. , <br /> Minimum (iGics��)t�38'n 7��� Square Feet with j 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 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�^ DE1vIED By the City of Orono subject to existing regulations and <br /> the following conditions:C-x�5 �,n� ��fcr��k m u �t � -� y=c.` y� ,�� ��<� �����_, c ' <br /> �y�s <br /> �- <br /> By: �.�� <br /> C � ence, -Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />