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�' �� SEPTIC SYSTEM APPROVAL <br /> � � _ pY <br /> � �g CO <br /> O O ��� <br /> � p ;:�:.. ,� C ITY of ORONO <br /> !�r Municipal Offices <br /> � � <br /> � 4 G Street Address: Mailing Address: <br /> � l� , ;¢�i ;. <br /> �CEgKO�� 2750 Kelley Parkway P.O. Box 66 <br /> _=' Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> ,�? <br /> Owner .�,�k � ��fl� G�/U f� Phone (Home) (Work) <br /> �ddress �t5��i /�"e� � i�au.� ,�r�. ��j�::,z�-d�l� ity C����2��1�� State �r�tN Zip <br /> Site Evaluator �- �' ���sf�-��c� State Lic nse # , 9 � Phone# �l`�7- .�S 66 <br /> Type of Establishment: � Single Family X_ Multi Family <br /> Commercial �,,;, Garbage Disposal Yes No <br /> No. Potential Bedrooms 5 Est. Gallons Per Day %��� <br /> Water Meter Required: Yes_ NoX Soil Sizing Factor . �� .�t5� �i {2 <br /> Perc Rates P-1 LI.� P-2�2,y P-3 3�( P-4 y.� P-5 ��� P-6 S. -7 <br /> Restricting Layer Depth B-1 /h" B-2 ��-" B-3 �.`" B-4 !�" B-5 �'C'` B-6 !��" <br /> Type of Treatment System: <br /> Standard_� 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 115� ����=-i? # of Tanks Z- Lift Tank Size 1'�`SU <br /> Pump Brand -- GPM .35 Head 2C� <br /> Treatment System: <br /> Minimum [��'� ezJ,�(ti3�`l5� 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 /> thefollowingconditions: /������t���N � 2C?` 5"-�� �r� ���n v f����� �ti�t Ur«;�,�;�F�lc� ���-� <br /> dR�vi wl4 � �����n� . <br /> -- � � <br /> By: v1 �l�ti ��� <br /> Chris Pence, On-Site Systems Manager <br /> �STaI fS O�C6�IIE'D F8� <br /> e�oo+r� �uw►i����auaie� <br /> ���nraua��s�,+s�n, <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />