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' SEPTIC SYSTEM APPROVAL <br /> '� � <br /> .� �SPBG�'S COPY <br /> � 0 <br /> , ;,,�,, � CITY o� ORONo <br /> .�� � <br /> Municipal Offices <br /> � �!� , 'E. G~;;; <br /> �9 g.� ; Street Address: Mailing Address: <br /> $'EggO ��� 2750 Kelley Parkway P.O. Box 66 <br /> --"' Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> n <br /> Owner�l��i� �c(qarlS Phone (Home) (Work) <br /> Address3��YS Jr�c'c�b� /"1%�ll��t. City ��.z���� State ,1>>� Zip —' <br /> Site Evaluator 5-,v�-bc.uY��s State License # Pfione# Y�t Z- S c�' SS <br /> Type of Establishment: Single Family �. Multi Family <br /> Commercial �� Garbage Disposal Yes x No <br /> No. Potential Bedrooms (, Est. Gallons Per Day �10�� <br /> Water Meter Required: Yes_ No� Soil Sizing Factor , �i 3( . ���?�i�Ft 2 <br /> Perc Rates P-1 2�' P-2 1� P-3 ',� P-4 a`� P-5�'2 P-6 2�,• P-7 <br /> Restricting Layer Depth B-1 I�" B-2 Z[>" B-3 (�'"` B-4 ly" B-5 3z�" B-6 �� ' <br /> Type of Treatment System: <br /> Standard ,X- Experimental Alternative <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 (5�'� /�«? # of Tanks 2-- Lift Tank Size �J��U <br /> Pump Brand C�^v� � c( GPM �5.� 5 Head �� <br /> Treatment System: <br /> Minimum (i o��7,`�y�3f?��-��5'�Square Feet with � inches of rock below pipe <br /> Type of covering Fabric L 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 allo���ed within 20' of tested drainf'ield sites ever. <br /> ACCEPTED_,� DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: U�E " �to �ti,c-{t l�� �r� ������r� ��°���,- ��ii.�t 5t �'�.- l�;" c <br /> �k'� ' �1 � r 'r✓r ct�. <br /> IF; <br /> $y: +�1� '-G%dL �r� �—V�" �'L' <br /> C ' Pence, On-Site Systems Manager <br /> ��STEM IS DESIGNED FOR <br /> dEDR00MS. ANY INCREASE IN NUMBER <br /> pF 81F�OMS INVALIDATES THtS DESIGN. <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />