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� � SEPTIC SYSTEM APPROVAL <br /> � O ��R g C4PY �JSP�CT01�t'S COPY <br /> � ;:\; $p , <br /> �0 � � � <br /> � � � �� �� CITY of ORONO <br /> r� ' j �� ' �+ ; <br /> , <br /> v�, , '; 15r,; Municipal Oftices <br /> a 'y�� <br /> � 1�` G �� Street Address: Mailing Address: <br /> l,� �� � ��'g,�v �, <br /> � $EggO,.,:� � 2150 Kelley Parkway P.O. Box 66 <br /> �-____� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner�j Ni.s ��r►�S Phone (Home) (Work) <br /> Address !l5� L�yv�q�J f��'�e n U F, City 'w1 R�2�z.�� State 1M,� Zip SS39� <br /> Site Evaluator h/PSi��?c�c� State License# '-�,3 Phone# !-��g--�b2 -258I <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial /✓� Garbage Disposal Yes �C No <br /> No. Potential Bedrooms 3 Est. Gallons Per Day �{S� <br /> Water Meter Required: Yes No K Soil Sizing Factor � 83 . (�Uyp� �f z <br /> Perc Rates P'�1�5 P�� P-3�1� P�,12 P-5 P-6 P-7—T <br /> Restricting Layer Depth B-l�" B-2 2�f'' B-3� B-4 3Z'` B-5.36" B-6 <br /> Ty�pe 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 /ODC� # of Tanks 'Z- Lift Tank Size !�4 p <br /> Pump Brand '—' GPM ��1 Head 2'�` <br /> � Treatment System: <br /> Minimum��d�3L�')t�3��xSb�� Square Feet with�inches of rock below pipe <br /> Type of covering Fabric >C 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 /> By: ' ..J /C-2�-G�.` <br /> ������ Chris Pence, On-Site Systems Manager <br /> $EDROO�dS. AlVY tI�C�J4SE I(�MU�BER <br /> t1F BED�#1�45 I�IAUQAtES THIS pES1G�i. � <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />