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• � SEPTIC SYSTEM APPROVAL <br /> , O _,, \\ .� <br /> ��� � � '��: 0'� OpZONO CU�PY <br /> � �� �� � O <br /> �: � ;�,:� __. �� �,o� CITY of ORONO <br /> �� r��,� � ,�� � ��t5r;�;� � Municipal Oftices <br /> ��� '. � `'��� Street Address: Mailing Address: <br /> `qkESHQ�'����q52� q`�y" `�`�gq 2150 Kelley Parkway P.O. Box 66 <br /> ' � ,����y ('�S 1ru c-��u��Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner T�, f ��.R�a I�R�►t}' Phone (Home)7KS-3`l73 (Work) bS6-322 j <br /> Address 36g0 5�4�'c�,(�s i�%l( 1�d City �ium� State �'In� Zip <br /> Site Evaluator Si.�1�DLur�D State License # Phone# 4�{2- ��SS <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial /��� Garbage Disposal Yes No <br /> No. Potential Bedrooms 5 Est. Gallons Per Day ?S� <br /> Water Meter Required: Yes No� Soil Sizing Factor . .3 �6t� �t� <br /> Perc Rates P-11�, P-2� P-3� P-4 �:� P-5 ZZ P-6 Zc� P- <br /> Restricting Layer Depth B-1 2N`� B-2 20`' B-3 2L�" B-4 Zti" B-5 Zy" B-6 Z!" <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 125��ioc� #of Tanks 2 Lift Tank Size I ZSc7 <br /> Pump Brand GP�1 �($ Head a3 � <br /> Treatment System: c� <br /> Minimum �rU�G�'�P-(39��e`� Square Feet with / inches of rock below pipe <br /> Type of covering Fabric X Other <br /> THIS IS NOT A PERl�7IT. This is a desi�n 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 chan�es 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 altemate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KIN"D is allowed wzthin 20' of tested drainfield sites ever. <br /> ACCEPTED � DENIED By the City of Orono subject to existing regulations and <br /> the follow-ing conditions: <br /> sy: i \ ���� 2 /-q <br /> Chris Pence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249--�616 <br />