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T �� ,� � � SEPTIC SYSTEM APPROVAL <br /> ' O - , '�ISPECTOR'S C�pY INSPECTOR'S COPY <br /> � � <br /> � Q �`'s�r-�.� <br /> ,� � � , � <br /> CITY of ORONO �`�x°R,��.�py <br /> �r Municipal Offices <br /> �� . ' G~ Street Address: Mailin Address: <br /> e9 4�,�' <br /> S <br /> �= -�ESI;�-�'� 2750 Kelley Parkway P.O. Box 66� <br /> - --''� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner�.�l+�t/� 7-�c�s, �1 h�, Phone (Home) (Work) <br /> Address J�25C� Ly;�rw� I?Ver�u�., City L�/'�y 2.�f� State /n� Zip 55��'� I <br /> Site Evaluatar --P �1�Psf�� State License #� Phone# y97-•35 E�(; <br /> Type of Establishment: Single Family SC Multi Family <br /> Commercial /�,��,'� Garbage Disposal Yes�_ No <br /> No. Potential Bedrooms � Est. Gallons Per Day b�� <br /> Water Meter Required: Yes No� Soil Sizing Factor . $3 � ,�{S x� F't�� <br /> Perc Rates P-121,� P-2 3� ] P-3 15� 1 P-4 y:9 P-5� P-6 j�',5 -7!�I, , �t:8'� t 5.,5� <br /> Restricting Layer Depth B-11� B-2 (b" B-3� B-4� B-5 �" B-6� <br /> Type of Treatment System: �A!�' Z�41?`= ,�:� i'�" �{,, ltir� s.� C�" <br /> Standard X. Experimental Alternative <br /> Pressurized Mound System x At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size 1 Q e� # of Tanks � Lift Tank Size (��� <br /> Pump Brand -- GPM �{p Head i$ ' <br /> Treatment System: <br /> Minimum (�o'XS's`� 4?�f g�7` Square Feet with�inches of rock below pipe <br /> Type of covering Fabric X 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 � DENIED By the City of Orono subject to existing regulations and <br /> thefollowingconditions: LtSc-` �n;,�;mu�n o�' �c� `` W�snec� s�wu� d-elO�J Ga�l .L Pdq.�, <br /> F ro G`. !11�-t v�+r�� 2 c.'�' S F r�a-ck f o ( �� �-�� l�`��s. �— <br /> By: �� ' -a�-� <br /> '�t��iS'i D�GMED f0l( Chris Pence, On-Site Systems Manager <br /> .,�.,�o�oo�. �nr nuc�asf n��uMs� <br /> �e�rowov�s��s tHrs�s� `�����-o� --� ����,-1 I��� 3 — 13�-� ���� ( f����kS <br /> �0 3019 �q��`�oo� � <br /> �G 1� C'�o i�' Telephone(612)249-4600 • Fax(612)249-4616 <br /> �`e i I P��� ��2- ��o-,�r�v �io<<- � �3�lrt��) <br />