HomeMy WebLinkAbout2014-00274 - new tanks mound system CITY OF ORONO * 2 0 1 4 —
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` 2750 KELLEY PARKWAY DATE ISSUED: 04/17/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 1560 TANGLEWOOD RD
PIN 26-118-23-32-0012
LEGAL DESC TANGLEWOOD
LOT 003 BLOCK 001
PERMIT TYPE SEPTIC
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE NEW -M tj l<.S
NOTE: (3)PRECAST CONCRETE TANKS,EACH 1,300 GALLON
EXISTING TREATMENT SYSTEM
APPLICANT SEPTIC NEW 200.00
STATE SURCHARGE SEPTIC 5.00
ELMER J. PETERSON COMPANY MISC FEE 0.00
5921 DAGUE AVE SE
DELANO,MN 55328 TOTAL 205.00
(763)972-2420 Payment(s)
Minnesota State License#: BUIL-219 CHECK 18696 205.00
OWNER
BUHMAN,DION&TANYA
1560 TANGLEWOOD RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By gnature Date
�J-�7q�,
O City of Oron OF F RCITY USE LY
P.O. Box 66 �IT
0 2750 Kelley Par ay D Received: �� Pe it# 1
Crystal Bay, MN 233
(952)249-4600 ate 1L
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CITY OF OR NO — S IC SYSTEM P Mb%APPLICATIOU—
(All permits mu t be a r an or u Official)
For Code omphan
Job Site / Owner Informs - r/y/ Q�►
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49
Site Address: Sa O
Owner: b%e7il IJv /L Iq Mailing Addr �SA T�P �ST
City: O Zip:
Home Phone: Alternate Phone:
Contractor/Applicant Information:
D
Contractor/App.: Contact Person:
Address: �`� 2 �.� W c �� S/—C State License #:
City.. DC-/CIA o Zip: � Expiration Date:
Phone: ��, � 2 ' 2- 2Alternate Phone:
TYPES OF OCCUPANCiy � ..:
❑ Residential ❑ Commercial ❑ Other
T{ }
New or Replacement System $200.00
Repair Existing System 100.00
(Tanks or Drainfield)
State Surcharge 5.00 5.00
Total $ cpo'5� dD
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1 / 2
* tE W 104 APPL Ax
Fill in all appropriate4414pIcs` d cheek°all'appropriate` oxes. _..
will be installing the following:
Tanks ` Fi
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�] Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other
y (list manufacturer)
Nt�rxrtar of an s: 1
a
_T'reaiment`System
Trenches s.f.
Mound s.f.
Gravel less s.f.
Chamber s.f.
NOTE: The contractor is required to provide an As-Built of the system before the
final inspection.
The undersigned hereby applies to the City of Orono for issuance of a septic system
installation permit, agrees to do all the work in strict accordance with ordinances of the City
and regulations of the State of Minnesota and certifies that all statements made on this
application are complete, true and correct.
�- �
Signature of Applicant Date:
MPCA License No.:
Staff Review: ❑ Accept ❑ Denied
Reviewer: Date:
Reason for Denial:
Comments (to be printed on inspection card):
W:\(Permits)\Septic Permit Application-Updated Surcharge 07-28-11.doc
2 / 2
CITY OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION
W � .
1. Applications for septic system permits may be mailed or submitted in person at the City
offices; however, permits will not be mailed out. The permit must be picked up in person at
the City offices and work must not begin unless the permit card is on the job site.
*** DO NOT MAIL PAYMENT WITH THIS APPLICATION ***
2. Permits will be only issued to contractors holding a Minnesota Pollution Control Agency
(MPCA) Septic System Installers License.
3. All work must be done in accordance with the approved septic system design.
4. The following inspections will be required for all septic systems:
A. Tank installation prior to covering.
B. Drainfield trench installation prior to covering. For mounds, inspection is required after
rough up, but prior to sand placement (sand must be jar tested for silt content) and
again during pressure distribution piping installation in the rock bed.
C. Final inspection to verify final cover depths and to verify that all pump station (where
required) components are functional and comply with codes.
5. MPCA licensed Installers or their DRP (Designated Responsible Person) shall be present
during all inspections.
A 24-HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS.
W:\(Permits)\Septic Permit Application-Updated Surcharge 07-28-11.doc
3 / 2
SEPTIC SYSTEM APPROVAL
Street Address: Mailing Address: Telephone: (952)249-4600
A� 2750 Kelley Parkway PO Box 66 Fax: (952)249-4616
F G� Orono, MN 55356 Crystal Bay, MN 55323 www.ci.orono.mn.us
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Address: 4�0 'A h. Q C-2 12
2 o vim✓ Home Phone.
Owner: Work Phone:
Site Evaluator: D S E V A So State License# 'F/e�
Site Evaluator Wone Number: '7l3 f c4'-cv77
TYPE OF ESTABLISHMENT Single Family: Multi-Family:
Commercial? Yes No Garbage Disposal? Yes No
Number of bedrooms: i /'" Est. gallons per day:
Water meter required? Yes No Soil sizing factor:
Perc Rates:
P-1 ,,�.{. P-2 YL /i— P-3 — P-4 — P-5 — P-6 — P-7
Restricting layer depth:
B-1 B-2 B-3 B-4 B-5 — B-6
TYPE OF TREATMEJNT SYSTEM
Standard: rx f 5 lel � Experimental: Alternative:
Pressurized mound system: ;/ At-grade system:
Gravity trenches system: Pressurized trench system:
Gravity trenches with lift: Pressurized bed system:
Holding tank with alarm:
Number of tanks: Septic Tank Sizes: 1.3670 .0- /3 " c'
Lift tank size: 1:3o o Pump brand: / / GPM: Head:
TREATMENT SYSTEM
Minimum: square feet with inches of rock below pipe
Type of covering: Fabric: Other:
THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. A permit must be
issued to a licensed septic contractor prior to installation.
NOTICE TO INSTALLERS. Any changes to the approved plans must have prior approval by the inspector. Call for
inspection 24-hours in advance.
ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and fencing must remain in
place until final site grading. Approval to pour footings will not be granted until Inspections Department has verified
the primary and alternate sites are protected.
NO VEHICULAR TRRAFFICE OF ANY KIND is allowed within 20' of tested drainfield sites ever.
ACCEPTED DENIED by the City of Orono subject to existing regulations and the following
conditions:
oti //v5 <« i u w 0 - oCi✓ S' vc
By: Date:
Printed Name:
i
C.0,py
INSPECwrOFI' S C
Joseph Olson D.B.A.
Rusty Olson's--Soil and Percolation Testing
Joseph J. Olson--MPCA License#810
11481 Riverview Rd. NE, Hanover,MN 55341
(763)498-8779 Fax(763)498-8290
Revised 3/29/14
October 31, 2013
Dion Buhman
1560 Tanglewood Road
Orono, Hennepin County
To whom it may concern,
I was contacted by Elmer J Peterson Company to design new septic tanks for the
proposed new swimming pool addition to the house at 1560 Tanglewood Road in the city of
Orono. The results of the design are as follows.
The existing septic tanks are in the proposed new swimming pool area and must be dug
out, removed and replaced.
The existing house has four bedrooms. 2-1300 gallon septic tanks and 1-1300 Gallon lift
station are to be installed. The first tank is to be placed in the same spot as the existing lift station
the flow line of the existing tank is at approximately Elv.-969.2. The inlet flow line of the
proposed new first tank should be approximately Elv.-968.5. The second tank and lift station
must have at least two feet of cover over the top of the tanks.
See drawing for the location of the new tank.
If you have any questions please call.
Sincerely,
Joseph J. Olson
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K I
UNIVERSITY
OF MINNESOTA
Septic System Management Plan
for Above Grade Systems
The goal of a septic system is to protect human health and the environment by properly treating
wastewater before returning it to the environment. Your septic system is designed to kill harmful
organisms and remove pollutants before the water is recycled back into our lakes, streams and
groundwater.
This management plan will identify the operation and maintenance activities necessary to ensure long-
term performance of your septic system. Some of these activities must be performed by you, the
homeowner. Other tasks must be performed by a licensed septic maintainer or service provider.
However, it is YOUR responsibility to make sure all tasks get accomplished in a timely manner.
The University of Minnesota's Septic System Owner's Guide contains additional tips and
recommendations designed to extend the effective life of your system and save you money over time.
Proper septic system design,installation,operation and maintenance means safe and clean water!
Property Owner Dion & Tanya Buhman
PropertyAddress 1560 Tanglewood Rd Property iD 09-117-23-14-0007
System Designer Rusty Olson Soil &i Perc Testing Phone 763-498-8290
System Installer Elmer J. Peterson Co. Phone 763-972-2420
Service Provider/Maintainer TBD Phone
Permitting Authority City of Orono Andrew Mack, AICP Phone 952-249-4626
Permit# 2014-0274 Date Inspected
Keep this Management Plan with your Septic System Owner's Guide. The Septic System Owner's Guide
includes a folder designed to hold maintenance records including pumping, inspection and evaluation
reports. Ask your septic professional to also:
• Attach permit information,designer drawings and as-builts of your system,if they are available.
• Keep copies of all pumping records and other maintenance and repair invoices with this document.
• Review this document with your maintenance professional at each visit;discuss any changes in product
use,activities or water-use appliances.
For a copy of the Septic System Owner's Guide,call 1-800-876-8636 or go to http://shop.extension.umn.edu/
http://septic.um.edu
Version 11/03/2010
- 1 -
UNIVERSITY Septic System Management Plan
for Above Grade Systems
' OF MINNESOTA
Your Septic System
--_Cleanout
Manhole
�pDe
60s-uC11110 of m owd r:P OaYbubt WAIA
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iopwil--"----
----
fn+m rumr tank
r, mOMdfom' 7
Septic System Specifics
System is subject to operating permit*
System Type:&Oil OHIOV*Q V* F-1 System uses UV disinfection unit*
(Based on MN Rules Chapter 7080.2200—2400) Type of advanced treatment unit
*Additional Management Plan required
Dwelling Type Well Construction
Number of bedrooms: Well depth(ft): ?
System capacity/design flow(gpd): ✓❑Cased well Casing depth:
Anticipated average daily flow(gpd): ❑Other(specify):
Comments Distance from septic(ft): 125'
Business? What type? Is the well on the design drawing?OY O N
Septic Tank
One tank Tank volume: gallons T Pump Tank 1300 gallons
Does tank have two compartments?OYY ON ❑ Effluent Pump make/model:
Two tanks Tank volume: 2600 gallons Pump capacity GPM
❑ Tank is constructed of Concrete TDH Feet of head
Effluent Screen type: None ❑ Alarm location Top of Pump Tank
Soil Treatment Area (STA)
Mound/At-Grade area(width x length): 24 ft x 60 ft 7 Cleanouts or inspection ports
Rock bed size(width x length): _ft x _ft Surface water diversions
Location of additional STA: Rear Yard Additional STA not available
-2 -
UNIVERSITY Septic System Management Plan
for Above Grade Systems
OF MINNESOTA
Homeowner Management Tasks
These operation and maintenance activities are your responsibility. Use the chart on page 6 to track
your activities.
Identify the service intervals recommended by your system designer and your local government.
The tank assessment for your system will be the shortest interval of these three intervals. Your
pumper/maintainer will determine if your tank needs to be pumped.
System Designer: check every 36 months
My tank needs to be checked
Local Government: check every 36 months
State Requirement: check every 36 months every 36 months
Seasonally or several times per year
• Leaks. Check(listen,look) for leaks in toilets and dripping faucets. Repair leaks promptly.
• Surfacing sewage. Regularly check for wet or spongy soil around your soil treatment area. If
surfaced sewage or strong odors are not corrected by pumping the tank or fixing broken caps,call
your service professional. Untreated sewage may make humans and animals sick.
• Alarms. Alarms signal when there is a problem; contact your maintainer any time the alarm
signals.
• Lint filter. If you have a lint filter, check for lint buildup and clean when necessary. Consider
adding one after washing machine.
• Effluent screen. If you do not have one, consider having one added the next time the tank is
cleaned.
Annually
• Water usage rate. A water meter can be used to monitor your average daily water use. Compare
your water usage rate to the design flow of your system (listed on the next page). Contact your
septic professional if your average daily flow over the course of a month exceeds 70% of the
design flow for your system.
• Caps. Make sure that all caps and lids are intact and in place. Inspect for damaged caps at least
every fall.Fix or replace damaged caps before winter to help prevent freezing issues.
• Water conditioning devices. See Page 5 for a list of devices.When possible,program the recharge
frequency based on water demand (gallons) rather than time (days). Recharging too frequently
may negatively impact your septic system.
• Review your water usage rate. Review the Water Use Appliance chart on Page 5. Discuss any
major changes with your pumper/maintainer.
During each visit by a pumper/maintainer
• Ask if your pumper/maintainer is licensed in Minnesota.
• Make sure that your pumper/maintainer services the tank through the manhole. (NOT though a 4"
or 6"diameter inspection port.)
• Ask your pumper/maintainer to accomplish the tasks listed on the Professional Tasks on Page 4.
-3 -
UNIVERSITY Septic System Management Plan
' OF MINNESOTA for Above Grade Systems :. Oit
Professional Management Tasks
These are the operation and maintenance activities that a pumper/maintainer performs to help ensure
long-term performance of your system. Professionals should refer to the O/M Manual for detailed
checklists for tanks,pumps, alarms and other components. Call 800-322-8642 for more details.
• Written record provided to homeowner after each visit.
Plumbing/Source of Wastewater
• Review the Water Use Appliance Chart on Page 5 with homeowner. Discuss any changes in
water use and the impact those changes may have on the septic system.
• Review water usage rates(if available)with homeowner.
Septic Tank/Pump Tanks
• Manhole lid. A riser is recommended if the lid is not accessible from the ground surface.Insulate
the riser cover for frost protection.
• Liquid level. Check to make sure the tank is not leaking. The liquid level should be level with the
bottom of the outlet pipe. (If the water level is below the bottom of the outlet pipe, the tank may
not be watertight. If the water level is higher than the bottom of the outlet pipe of the tank, the
effluent screen may need cleaning,or there may be ponding in the drainfield.)
• Inspection pipes. Replace damaged caps.
• Baffles. Check to make sure they are in place and attached, and that inlet/outlet baffles are clear
of buildup or obstructions.
• Effluent screen. Check to make sure it is in place; clean per manufacturer recommendation.
Recommend retrofitted installation if one is not present.
• Alarm.Verify that the alarm works.
• Scum and sludge. Measure scum and sludge in each compartment of each septic and pump tank,
pump if needed.
Pump
• Pump and controls. Check to make sure the pump and controls are operating correctly.
• Pump vault. Check to make sure it is in place;clean per manufacturer recommendations.
• Alarm.Verify that the alarm works.
• Drainback. Check to make sure it is operating properly.
• Event counter or run time. Check to see if there is an event counter or run time log for the pump.
If there is one, calculate the water usage rate and compare to the anticipated average daily flow
listed on Page 2.
Soil Treatment Area
• Inspection pipes. Check to make sure they are properly capped. Replace caps that are damaged.
• Surfacing of effluent. Check for surfaced effluent or other signs of problems.
• Lateral flushing. Check lateral distribution; if cicanouts exist,flush and clean as needed.
• Ponding. Check for ponding. Excessive ponding in at-grade and mound beds indicates
problems.
All other components—inspect as listed here:
-4-
UNIVERSITY Septic System Management Plan
figs
OF MINNESOTA for Above Grade Systems
Water-Use Appliances and '
Equipment in the Home
Appliance Impacts on System Management Tips
- Uses additional water. - Use of a garbage disposal is not recommended.
- Adds solids to the tank. - Minimize garbage disposal use.Compost instead.
Garbage disposal - Finely-ground solids may not settle. - To prevent solids from exiting the tank,have your
Unsettled solids can exit the tank tank pumped more frequently.
and enter the soil treatment area. - Add an effluent screen to your tank.
- Washing several loads on one day - Choose a front-loader or water-saving top-loader,
uses a lot of water and may overload these units use less water than older models.
your system. - Limit the addition of extra solids to your tank by
- Overloading your system may using a liquid or easily biodegradable detergents.
Washing machine prevent solids from settling out in - Install a ling filter after the washer and an effluent
the tank.Unsettled solids can exit screen on your tank.
the tank and enter the soil treatment - Wash only full loads.
area. - Limit use of bleach-based detergents.
- Think even—spread your laundry loads
throughout the week.
- The rapid speed of water entering - Install an effluent screen in the septic tank to
2°d floor laundry the tank may reduce performance. prevent the release of excessive solids to the soil
treatment area.
- Be sure that you have adequate tank capacity.
- Powdered and/or high-phosphorus - Use gel detergents. Powdered detergents may add
detergents can negatively impact the solids to the tank.
Dishwasher performance of your tank and soil - Use detergents that are low or no-phosphorus.
treatment area. - Wash only full loads.
- New models promote"no scraping". - Scrape your dishes anyways to keep undigested
They have a garbage disposal inside. solids out of your septic system.
- Finely-ground solids may not settle. - Expand septic tank capacity by a factor of 1.5.
Grinder pump(in Unsettled solids can exit the tank - Include pump monitoring in your maintenance
home) and enter the soil treatment area_ schedule to ensure that it is working properly.
- Add an effluent screen.
- Large volume of water may - Avoid using other water-use appliances at the
Large bathtub overload your system. same time.For example,don't wash clothes and
(whirlpool) - Heavy use of bath oils and soaps can take a bath at the same time.
impact biological activity in your - Use oils,soaps,and cleaners in the bath or shower
tank and soil treatment area. sparingly.
Clean Water Uses Impacts on System Management Tips
High-efficiency - Dnp may result in frozen pipes - Re-route water into a sump pump or directly out
furnace during cold weather. of the house.Do not route furnace recharge to
your septic system.
- Salt in recharge water may affect - These sources produce water that is not sewage
Water softener system performance. and should not go into your septic system.
Iron filter - Recharge water may hydraulically - Reroute water from these sources to another
Reverse osmosis overload the system. outlet,such as a dry well,draintile or old
drainfield.
Water from these sources will likely - When replacing consider using a demand-based
Surface drainage overload the system. recharge vs.a time-based recharge.
Footing drains - Check valves to ensure proper operation;have
unit serviced per manufacturer directions
-5 -
UNIVERSITY Septic System Management Plan ^
for Above Grade Systems
OF MINNESOTA
Maintenance Log
Track maintenance activities here for easy reference. See list of management tasks on pages 3 and 4.
I214k
Activity Date accomplished
Check frequently:
Leaks: check for plumbing leaks
Soil treatment area check for surfacing
Lint filter: check,clean if needed
Effluent screen: if owner-maintained
Check annually:
Water usage rate(monitor frequency_)
Caps: inspect,replace if needed
Water use appliances—review use
Other:
Notes:
Mitigation/corrective action plan:
"As the owner of this SSTS, I understand it is my responsibility to properly operate and maintain
the sewage treatment system on this property, utilizing the Management Plan. If requirements in
this Management Plan are not met, I will promptly notify the permitting authority and take
necessary corrective actions. If I have a new system, I agree to adequately protect the reserve
area for future use as a soil treatment system."
Property Owner Signature: Date
Management Plan Prepared By: Elmer J. Peterson Co. Certification# L0219
Permitting Authority: City of Orono - Andrew Mack, AICP # 8922
®2010 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer.
This material is available in alternative formats upon request. Contact the Water Resources Center,612-624-9282. The Onsite Sewage
Treatment Program is delivered by the University of Minnesota Extension Service and the University of Minnesota Water Resources Center.
-6-
INSPECTION NOTICE
DATE TIME
CITY OF. U Q44Vto CALLED-IN
SCHEDULED I/.'vim `r 4
PERMIT NO.olo Y- 66 7 COMPLETED
ADDRESS fs d 1, tic 4 cb-O. �2
OWNER/CONTR. -
❑SITE INSPECTION ❑MECHANICAL RI ❑REINSPECTION
❑CONC SLABS ❑MECHANICAL FINAL ❑FOLLOW-UP
❑FOOTING ❑INSULATION ❑COMPLAINT
❑POURED WALL ❑RATED ASSEMBLY ❑FIREPLACE
❑FOUND.DRAINAGE ❑BUILDING FINAL / ❑SPRINKLER SYSTEM
❑FRAMING SEPTIC INSTALL JF/1 w�r5 ❑
❑SHEATHING ❑SEPTIC FINAL ❑
❑PLUMBING RI ❑S&W HOOKUP ❑
UL ❑PLUMBING FINAL ❑GAS LINE MANOMETER ❑
y COMMENTS:
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CL I
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cc FURTHER CORRECTIONS MAY BE REQUIRED ❑ PERMIT FINALED
W ORK SATISFACTORY: PROCEED 11PHOTO TAKEN
O '0 CORRECT WORK&PROCEED
U ❑CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING
❑CORRECT UNSAFE CONDITION IMMEDIATELY.
O STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
TO SCHEDULE YOUR INSPECTIONS
PLEASE CALL: (763)479-1720
Metro West Inspection Services Inc.
Owner/Contr.onn e:
Inspector-
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED
PERMIT NO.����l Z 14 COMPLETED L / Of 2,71
ADDRESS_,z�D ` a✓�a�c�c�o 11 c9
OWNER TELEPHONE NO.
CONTRACTOR
3Z DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL AEPTIC FINAL
❑ POURED WALL ❑ PLUMBING RI CAV/GRADING/FILLING
C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARDCOVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
0 COMMENTS: ✓ �1 g �i2
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W ❑WORK SATISFACTORY PROCEEDOJECTCOMPLETE
QCW
❑CORRECT WORK 3 PROCEED ❑ISSU ERTIFICATE OF OCCUPANCY
0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContra r on site: e2 0
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
METRO WEST INSPECTION SERVICES, INC. ® 763-479-1720
BOX 248 • LORTTO, MN 55357
CITY OF Of -&,i c,
WORKSHEET FOR SEWAGE DISPOSAL WORK
Date 4 - 2 2- f
Inspector Building Permit No. !ZO/4( -662 9q
Owner 0-49 164 M -n
Property Address Z,1 !/" &-A®C)J Q11
Kind of Building
SSTS Installer ce License #
Septic Tanks
Materials �=r�=fi Number of Tanks 3
Size 13,60 �6v1
Drain Field: rx S vl`-Aq
Total length of lines Number of lines
Type of soil Percolation Test
Width of trench Type of filter material
Size of Rock Bed Size of Absorption Area
Draw detailed diagram with measurements indicating distances to septic tank risers from a
permanent structure.
F' 5 i-0 4 -
0
1560 Tanglewood Road