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11/16I2095 13;39 3202382343 HENTGES I <br /> . CUSTOMER: PdGE 05 <br /> Name: B�rns �xcavetin <br /> Street Addness: <br /> City, St�t�, Zip Cvt��: <br /> Phones: (H) WoMc Celi <br /> � <br /> SITE aDDR�SS: <br /> Street: 509 �erndale Road �lorth <br /> C�tY Or�no MN 55356 <br /> TOwn$hip � � � <br /> P1D <br /> pate of design 12-02-05 <br /> System Trtl�vrmation __ New � X Replacement <br /> TYPe �fi sY9�m �„�x Rock'�ren�h � �r�ve►le�s trench <br /> Mound � At-Grade <br /> Chamb�r � ,A�fernative <br /> T�rpe of establishmenQ Sin le Famil Home <br /> ��ptic t�nk infiormation No. � siZ� Of us8bl@ eXlBting t�anks: 2000 gailofl tBnkS <br /> — �r <br /> No, & size of new septic tanks: 10D0 gall�n tank <br /> �� <br /> "' I� there a grindedejector pump used in t�e �ystem? n� � <br /> (Checl��ar additional siring req�Irr�mQnts end o0mpartmentaliza�no w�t11 LUG) <br /> Pump �nk info�nati�� Size of pump tank 1p00 galbn� <br /> uite considera�ions �1 Propane ot natural gas lines in way? <br /> ___„_ Under ground electric lines in way? <br /> Geble or phone lines in way? <br /> � Buried w�ater lines in way? <br /> ,�.�_ Existing sept�c tank to pump and inspect? <br /> _...,� Old sep#ic�anks to pump and bury? <br /> __ Septic tank firuck access awailable? <br /> __ x Trees to be removed? <br /> ________ Difficult fat��&drainfield equipment��/werk�bA��� <br /> Other. <br /> � �✓erience required? ��Oescribe <br /> � <br /> PAGE 2 OF �� <br /> � 'd lh l '��1 I�NddWO� ���38NHa Wd00 � l l SOOZ '8 '�3a <br />