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, <br /> . , . <br /> � - SEPTIC SYSTEM APPROVAL <br /> 0 <br /> �' � <br /> �� 0 0 <br /> � <br /> � ��� ,:,, ,� � CITY of ORONO <br /> r�`,, „ !4;, Municipal Offces <br /> � , � G~ � Street Address: Mailing Address: <br /> ���9$EggOg'���� 2750 Kelley Parkway P.O. Box 66 <br /> - -'� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ,jf �'� �i�r�-��f Phone (Home) _�tl�-r��-�, (Work) �J�- �SG�= <br /> Address :�b75� �����b's 6r1�`[l ,�d. City Lr�e�r� State �N Zip <br /> Site E�-aluator 7<<�Z Oc u�2a`� State License# Phone# yY"2 - �5 c�SS <br /> Type of Establishment: Single Family x Multi Family <br /> Commercial /�,_� Garbage Disposal Yes No <br /> No. Potential Bedrooms IQ `� Est. Gallons Per Day � (�p�R <br /> Water :�leter Required: Yes_ No� Soil Sizing Factor . F.j (,6 C s�d�{�i��� <br /> Perc Rates P-1 '1'L�r P-2� P-3 �7`� P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 B-2 B-3 B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard X- Experimental Alternative <br /> Pressurized Mound System X- At-Grade System <br /> Gravit�- Trenches System Pressurized Trench System <br /> Gravit�- Trenches W/ Lift Pressurized Bed System <br /> Holdina Tank W/Alarm <br /> Septic Tank Size /�C��� # of Tanks 2 Lift Tank Size l�C�t� <br /> Pump Brand -- GPM 5 f� Head "L ;� <br /> Treatment System: � ��' <br /> Minimum ����x s�`,� ' y.�'* �y�` Square Feet with � inches of rock below pipe <br /> Type of covering Fabric j� 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 />. fencin� 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 follo�ving conditions: <br /> � <br /> l�Rt�IS. ��1N� By: ��-i Z-l'_ `��t <br /> �����► C ' ence, On-Site Systems Manager <br /> -� 7'btt S l'�Ps`19�J ti'w..� Su 6;-►mr N�c� � C�(cr�tYz � 64(�F2�7��`ivF 5,� � f-a � <br /> �y i ��►1�+r��� .S�'��� a�� U r c t' L'�/1,5�). <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />