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, � SEPTIC SYS'I'EM APPROVAL <br /> ,; �' -�� �� :���� �-�-��•� - _.. <br /> %� � ��, ,�:� �, ��% � � � � <br /> �� � � '���.;F.r'� f <br /> „ o O � 4_ � _�-s- . <br /> 4 � � <br /> �q �.� .,f;,. �, �� �ITY of O�ON� , � <br /> ,� , , , , . <br /> , <br /> ��\",�'+� � ���ti`. 'r b�, ti�� Municipal Offices ' <br /> � / � �.— ; ' ' �� <br /> �� ��' � ��'�����'��'��������`��`�� G" Street Address: Mailing Address: <br /> \��9 � �; ,¢�i j <br /> ���E$H��% 2150 Keiley Parkway P.O. Box 66 <br /> �`___�� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address a 9'a d Kok 5�-. City State Zip <br /> Site Evaluator5-�e�� Sc�:r���s State License # ��:t7 Phone# 76�-- 4`1�- 3S6G <br /> Type of Establishment: Single Family_� Multi Family .r <br /> Commercial Est. Gallons Per Day 7 5c,� <br /> No. Potential Bedrooms � Slope: 3-6 `�a � � � <br /> Depth of Sand: Upslope: i1 Downslope: ►.S�} !.£l Soil Sizing Factor <br /> Perc Rates P-1 �y. I P-2 3.� P-3 g.�: P-4 14. I P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 a$ " B-2 �$" B-3 �," B-4�� B-5 �-" B-6 26 " <br /> Type of Treatment System: <br /> Standard�_ Alternative Other Performance <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/Alarm <br /> Septic Tank Size i1Sv a' �o�'�' # of Tanks �- Lift Tank Size �d�� <br /> Pump Brand GPM "�� Head � 6 <br /> Treatment System: <br /> Minimum Square Feet with � inches of rock below pipe <br /> Mound Bed��X Mound Treatment Area �i I x 9 n 4 I �c 1 ��� <br /> , <br /> THIS IS NOT A PEI2MIT. 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 th��Eo���,���i���ri�,a�proval of the <br /> inspector(952-249-4600) Call for inspection 24 hpurs`ii�ac�Van�e' '�'"'�' f""`' t �'�r���z�<*����r�,�� <br /> r . ._: ..,.s x , s71 o„s . sr..:�ar5 trut(tf:�,:rT�aet.,� <br /> ALL DRAINFIELD AREAS MUST BE FENC�D O�'F p�ic�-.ta�bui�c�i��g;s�,,,�c�����nd <br /> .. ,�. <br /> fencing must remain in place until final site grading ��Jj�p�ova�'to�ou��fd�t�in��vV�'���3C�e�granted <br /> until the Inspections Department has verified the prtnzaryzand alterx�a��s�te5 are p�o�eC���i. <br /> NO VEHICULAR TRAI+FIC OF ANY KIND is alla'vf�ed withln 2b'.��eS��l�Pai�"5n`�S`�'ver. <br /> ACCEPT�D�_ D�NI�D By the City of Oroi�o subject to exisfii-ig reg"�u a i"'on'�"'and <br /> tl�e following conditions:_ �' `'���f� ���t''�' !�'t=t.Ii.tP� <br /> - �}{c� f�-�JS� �� ��Y � ��. . , �.it. f?i� ..3.�':w3 <br /> gy: ��. � ��n-R� �-/�-0� <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4G00 • Fax(952)249-4616 <br /> www.ci.orono.mn.ns ' <br />