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_ . , SEPTIC SYSTEM APPROVAL <br /> � ��7{ f;� x 3�. �: -::�s�wj� . . � ., y,a ,F�� as-�w.w <br /> f� ` ,�� � � �. ..: � -,. <br /> i" <br /> � �'y � <br /> O� �Y Y� � �W+•Y X �a�p I r•� �V�'� . <br /> O . ':. O <br /> -'�' �� "-� Ci��� O� ���N� <br /> 1� ,'3'� l�''' ;� � ', <br /> �, Municipal Offices <br /> �\�,� -�� �:;-,�".A G� <br /> ,,\ ,�� ' �.�� Strest AddrEss: Mailinb Address: <br /> � �E��p 2150 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address �'2 5 gR��,,) R� 5 City State Zip <br /> Site Evaluator��k�J�c' rn����2 State License# L(3 Phone# ��z}bs3 z-c�5�7 <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day ��j'Z� <br /> Water Meter Required: Yes No� Soil Sizing Factor /� 6 7 <br /> Perc Rates P-1 15 P-2� P-3 /6 P-4� P-5 !8 P-6_� P-7 <br /> Restricting Layer Depth B-1� B-2 5U" B-3 56" B-4Nm�. B-5 SY`" B-6 So" <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 G,c�vC!Ps3 Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size (3�0 # of Tanks 2 Lift Tank Size 13o� <br /> Pump Brand 'l3 h� GPM Head <br /> Treatment System: <br /> Minimum j 2 52 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 pernut 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 buildina 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_� DElvIED By the City of Orono sub' t to exis-ting regulations and <br /> the following conditions: <br /> � <br /> By: �� <br /> _ _, .__._-- <br /> C ' Penc , On-Site Systems Manager <br /> %�t rk-�� <br /> � � c <br /> �� ��'�r!� - <br /> 1 � —� Telephone(612)249-4600 • Fax(612)249-4616 <br /> J � <br />