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. � <br /> � ' SEPTIC SYSTEM APPROVAL <br /> o �Rd���� ��°��� <br /> � � <br /> 0 0 <br /> � <br /> j ,, , ,� CITY of ORONO <br /> �`,, ,�ti Municipal Offices <br /> �.�� .�G Street Address: Mailing Address: <br /> xESII04' 2150 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ��':���y � �i���� Phone (Home) (Work) <br /> Address 3�E�`' �t�SS�tX �<< City h�-'^�' State M/'V Zip <br /> Site Evaluator �;�»;� .•w.;��Z;- State License # f'��i�i Phone# �:�tC'� � 3 1�- ,�7►�] <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Est. Gallons Per Day 7 S t`� <br /> No. Potential Bedrooms � Slope: 3�'/c` <br /> Depth of Sand: Upslope: Downslope: Soil Sizing Factor �, � <br /> Perc Rates P-1 i3. P-2 :�� P-3 � P-4�_ P-5 i3. I P-6 ,lc` P-7 <br /> Restricting Layer Depth B-1 5�'' B-2 y"f`' B-3 5.� ' B-4 ��-c B-5 B-6 <br /> Type of Treatment System: <br /> Standard�c Alternative Other Performance <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 � 3Ci� # of Tanks �. Lift Tank Size i 3�''� <br /> Pump Brand GPM �5 Head �C� •� <br /> Treatment System: <br /> Minimum � >��' � Square Feet with ; � inches of rock below pipe <br /> Mound Bed Mound Treatment Area <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 �C DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> X (01 ZC�.' � ��` �— !�i'.Lt ( � ���\fC�'�. '1ZavCL �l�C"J�C. Jt�+ 1': � <br /> C'�( �CA. � <br /> By: ���. 1 ::3�-2�-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 />