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, <br /> SEPTIC SYSTEM APPROVAL <br /> o � �nt� C � <br /> � � , <br /> 0 0 <br /> � <br /> , �r�. � CITY of ORONO <br /> � �4. ' �, Municipal Offices <br /> ti <br /> �,�9 ¢,�G Street Address: Mailing Address: <br /> �ES�I� 2150 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address ��►� S a�-er;�-, t��� City ��c� ���> State Zip <br /> Site Evaluator �����i �,��� State License # `���' Phone# �6��- y��5- �7�`� <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial Est. Gallons Per Day �-s�� �o v <br /> No. Potential Bedrooms 6 Slope: `� ��o <br /> Depth of Sand: Upslope: 1 Downslope: I, �i Soil Sizing Factor �. `3 3 <br /> Perc Rates P-1 7 P-2 �-'� P-3 S- y P-4 S-1 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 �.� B-2 �.1 B-3 �.� B-4 a.� B-5 ;�.G B-6 �..� <br /> Type of Treatment System: <br /> Standard � Alternative Other Performance <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!a� �� # of Tanks � Lift Tank Size ISdU <br /> Pump Brand GPM �� � Head I � <br /> Treatment System: <br /> Minimum Square Feet with � inches of rock below pipe <br /> Mound Bed I ox ?r�� Mound Treatment Area yc k ��, �i�>n i�'>� <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 (952-249-4600) 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 /> '_ t�ZC �1,.,....�,v��: �G<< L� r�L.e�� �',� �;.0 �"�) CSS.�J�I -��y^� wt1��`'r•�� <br /> i <br /> r--�r ;5 �� �1����� 7�� � 5 v�f ;���� '.S c�(�..+s� r��✓c i�G ex�.cT <br /> 1f1tAF�,I.�•. Ch �vCY�4�(� V��C.�:"L(� . <br /> By� " ���� ����,�-,r-s -__ � C-�`�'C�� <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />