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, , � , SEPTIC SYSTEM APPROVAL /`� <br /> =-_�" �!� �/ <br /> �-�.o <br /> , ,\ �/ <br /> � - � <br /> � .� <br /> � <br /> � � � <br /> �o � <br /> ll -- , �'� CI'�Y of OR011�0 <br /> , <br /> 'i.,',, +a � '� - ~ ,�!I <br /> �, , � 15�!j Municipal Offices <br /> v� -: <br /> �������' � � � �'�� G�� <br /> � Sire?t A�drass: hlail9ng Address: <br /> �`9�' O�� �� 2750 Kelley Parkway P.O. Box 66 <br /> � E,$H� <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address � 7.�5 ��c� i�u,, ":',�- ,'� �-. City C' > �F;�� State ��1� Zip <br /> Site Evaluator N ��rCav.�+,'„• State License # G`/`( Phone# ti c�7-- 3�/3� <br /> Type of Establishment: ingle Family_�_ Multi Family <br /> Commercial ,�:�� Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 75� <br /> Water Meter Required: Yes_ No� Soil Sizing Factor , �3 [,�5 y�d/F{L� <br /> Perc Rates P-1 �:�;.%"• P-2 '���'- P-3�t�='> P-4_�i�:� P-5 .3C` P-6 '-1C� P-7 <br /> Restricting Layer Depth B-1 <��" B-2�` B-3 Z " B-4 2�" B-5 'y S" B-6 z y,; i3-7 2Z� <br /> Type of Treatment System: <br /> Standard X- Experimental Alternative <br /> Pressurized Mound System � At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches GV/Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size J.SE c�� # of Tanks Z- Lift Tank Size �i5�C''` <br /> Pump Brand GPM '!E� Head �E'�' <br /> Treatment System: <br /> Minimum�iG�G� � ,r�Yo"��3� Square Feet with�inches of rock below pipe <br /> —�— <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 following conditions: <br /> By: <br /> Chris Pence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />