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� SEPTIC SYSTEM APPROVAL <br /> L--#-... <br /> O- _ �.'�TSPEC°r���.'� �e`��F}"X <br /> � � <br /> O O <br /> '`��y°1=�T� ��=Y CITY of ORONO <br /> ,� r }�• ?� <br /> "� <br /> ti Municipal Offices <br /> � ti <br /> � f ' G � Street Address: Mailing Address: <br /> l.q g,� ;, <br /> �� ��kE8H0� 2150 Kelley Parkway P.O. Box 66 <br /> � -_ - _— Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address 3 76C' T��p�;s i��;l� i?�f City v'/����� State dr1r� Zip <br /> Site Evaluator 5t,tlt;pLu�t(L State License # Phone# y�2-- 5��� <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial /�� Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 75� <br /> Water Meter Required: Yes_ No X Soil Sizing Factor � �3 ` r6�� 2 <br /> Perc Rates P-1� P-2 [5 P-3 /� P-4 /S P-5� P-6 2"c� P-7 <br /> Restricting Layer Depth B-1� B-2 ZZ" B-3 �?b" B-4�?�f`� B-5 Zz" B-6 ZN" <br /> Type of Treatment System: <br /> Standard � 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 /25��ICt%� # of Tanks �Z Lift Tank Size !`L`�`� <br /> Pump Brand GPM �t 7 Head �7� 5 � <br /> Treatment System: <br /> Minimum (,�dF�z`)w (3�`w�6�� 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 HIND is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED x DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> � <br /> By: 1�i' �ZGc� 2-1—` 9 <br /> Chris Pence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />