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- SEPTIC SYSTEM APPROVAL <br /> INSPECTOR'S COPY <br /> � <br /> � � <br /> � � <br /> � ? ��� � <br /> ` �SPE�oR•S�o�ITY of ORONO <br /> � ti Municipal Offices <br /> "�,t� �,�, <br /> l� � ��g,� ;% <br /> Street Address: Mailing Address: <br /> kE88�_�.= 2750 Kelley Parkway P.O. Box 66 <br /> � ' Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address 3(���� <j.��?�, i?1+�IC l�d City G/uri��� State ��7��.3 Zip <br /> Site Evaluator 5 w'�Dt�-t���� State License # Phone# ��t 2.-���i S�' <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial /L��� Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 7 > <br /> Water Meter Required: Yes No� Soil Sizing Factar ��';3 64 � �f� <br /> Perc Rates P-l� P-2� P-3 ;a�t( P-4 Z� P-5 �Z P-6 ���? P-7 <br /> Restricting Layer Depth B-1 ;�,c�"` B-2 ;;?E;" B-3 i�" B-4 3C:'` B-5 'L�(� 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 /> Holding Tank W/Alarm <br /> Septic Tank Size /z 5� ��e�0 # of Tanks Z Lift Tank Size�u <br /> Pump Brand — GPM �{7 Head ,32 ` <br /> Treatment System: c� <br /> Minimum (��xb z' � 3`ln�'E� Square Feet with / 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 � DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> � � <br /> By: �u'�P"�`-ti !Z/�' <br /> Chris Pence, n-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />