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, SEPTIC SYSTEM APPROVAL pQ G �-� <br /> � - __ Y <br /> , , _ .. <br /> � <br /> 4.� ����+c�o�r <br /> O O <br /> > f,. ,� CITY of URONO <br /> � �r, ' Municipal Offices <br /> �� , � � G~ et Address: Mailin Ad r • <br /> Stre g d ess. <br /> � ��`91fE+ggOg'���� 2150 Kelley Parkway P.O. Box 66 <br /> - _% Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> "r ; <br /> Owner %���]G'�� �z�>7.5���c`�I���� Phone (Home) (Work) <br /> Address f71� �`�'���wt-k F�e�� �d City �Zi���t�` State G11�-' Zip <br /> Site Evaluator S F� i�'�i���«. State License # a�y Phone# ��t1-s�-i/ <br /> Type of Establishment: Single Family .� Multi Family <br /> Commercial /U� Garbage Disposal Yes No <br /> No. Potential Bedrooms �� Est. Gallons Per Day `loc-� <br /> Water Meter Required: Yes_ No ;x Soil Sizing Factar , (��• �� � �f Z <br /> Perc Rates P-1 �: � P-2 2,7 P-3 y,S P-4 ��� P-5 p?,7 P-6 �, P-7 <br /> Restricting Layer Depth B-1 S�i" B-2 Kt�'` B-3 �tz`` B-4 Yz" B-5 .�-�" B-6 .;-1`' <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 ��5���vt:�� # of Tanks � 1 Lift Tank Size� �S�t� <br /> Pump Brand GPM ��� Head .5 7 <br /> Treatment System: � <br /> Minimum t8;�I�3')�- ���-5� ��� 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 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: (,�,yR����ce.% /tr�s /k�n �Arr��=v ��;��' il/ell s�rb.�c«s,���', �'�� 6 ��'f��k <br /> 5�t'r�.Lt-'' �C��r : Gt � �/� /���C'S {rl U'S - � C�`�rv� � k t ` "' � t� �v � C'7�i0� l.. <br /> By: <br /> ����� Chris nce, On-Site Systems Manager <br /> �OR�OM�. ���',AS�p!#lUA�BER <br /> ��MI�iNt��iNS DESIt,�i. <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />