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SEPTIC SYSTEM APPROVAL � <br /> R <br /> � <br /> , �l <br /> 4 <br /> o CO <br /> , �y <br /> � � ,, <br /> , o 0 <br /> f�.� ,� CITY of ORONO <br /> \\�� ��� �,� ��'4 . , G�lSr Municipal Offices <br /> Street Address: Mailing Address: <br /> ���`9�C'EgHO�'�� � 2750 Kelley Parkway P.O. Box 66 <br /> _- Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �o�y C"�be� C_o . Phone (Home) (Work) <br /> Address 39S SuSSeX ���� City Oco�O State Zip <br /> Site Evaluator l�e�� � \"�'.\\c� State License # �°��,` Phone# 3�,0- 3�1�d- �.�1�{ <br /> Type of Establishment: Single Family >( Multi Family <br /> Commercial Garbage Disposal Yes�� No <br /> No. Potential Bedrooms � Est. Gallons Per Day 9 o O <br /> Water Meter Required: Yes_ No X Soil Sizing Factor U. �3 <br /> Perc Rates P-1 33 P-2 a6 P-3 a�s P-4�3 P-5 3� P-6 ZS" P-7 <br /> Restricting Layer Depth B-1 �.0`6� B-2 I.�6 � B-3 i.`�' B-4 �.as� B-5 I.as� B-6 �.6>' <br /> Type of Treatment System: <br /> Standard X 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 1300 # of Tanks � Lift Tank Size 1300 <br /> Pump Brand GPM 4 a Head ��� <br /> Treatment System: <br /> Minimum (I o x�5� 4�x �o�� Square Feet with � inches of rock below pipe <br /> e <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 (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'oftested drainfield sites ever. <br /> ACCEPTED X DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: �C v'>z ��5 �U-�- h�e. S��tw� �,y 5�a�.,�,-.� ��. 1 a�s _ <br /> f�C� c�c�. .i �C �+�i1. � n Ch S �(�S G r �.. {�"` C^C ,} C� 6 �hCC r a n r,. St{9 t,c � <br /> By: �� 9- Ia- al <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />