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. SEPTIC SYSTEM APPROVAL <br /> . - _� <br /> ��-� \\\ . � : <br /> �' / � � \�\.,\ ' °�� �' e'��� � <br /> i� O O '`, <br /> , : 1�,,. ,� ; CITY of ORONO <br /> ' ,� r <br /> � � fy ,�� ti �; Municipal Offices <br /> ti�i <br /> �\'� �� F ` �`� G ' Street Address: Mailin Address: <br /> ��� ESH g�� 2750 Kelley Parkway PA gBox 66 <br /> � $' O � <br /> �_-� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �0 ny E�d e„ C o . Phone (Home) (Work) <br /> Address��'r ` ' ° a�,5�5 S�sxX�''`�ity o�0�0 State Zip <br /> Site Evaluator f�e��.c M���c� State License # tga� Phone# 3a0 -3`1�6-�7r� <br /> Type of Establishment: Single Family � Multi Family <br /> Commercial Garbage Disposal Yes�_ No � <br /> No. Potential Bedrooms S Est. Gallons Per Day 750 ��� y � 6") <br /> Wa�er Meter Required: Yes_ No X Soil Sizing Factor O. � 3 r <br /> Perc Rates P-1 Ss.S� P-2 a3 P-3 �a P-4�� P-5 I� P-6 ly P-7 �d�^-�=ar 3 � <br /> Restricting Layer Depth B-1 �.33 B-2 a.� B-3 a.�S B-4 i.33 B-5 i.33 B-6 I.�> <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 � Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size 13 OU # of Tanks � Lift Tank Size I 0(� <br /> Pump Brand GPM 46�6 Head 30 <br /> Treatment System: <br /> Minimum (�ox 63�(ti5x�dS� Square Feet with inches of rock below pipe <br /> Type of cover ni g 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 (952-249-4600) Call for inspection 24 hours in advance. <br /> ALL DRAI�FIELD :�REAS 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 X DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> By: �C�C q��� '� � <br /> Matt Bolterman, On-Site Systems Manager � Date <br /> � <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />