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SEPTIC SYSTEM APPROVAL <br /> O <br /> ® <br /> IPUL <br /> 0 <br /> CITYof ORONO <br /> M' ;'CVs �• ti Municipal Offices <br /> ._? G <br /> Street Address: Mailing Address: <br /> `9�CEggOg' 2750 Kelley Parkway P.O. Box 66 <br /> -- Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner '0114. E �2n Phone (Home) (Work) <br /> Address 3015yvgter-town City o roc-,o State Zip <br /> Site Evaluator Ger e w,\\ec State License # 1 co\1 Phone# 3 ao- 399- a?o 5 <br /> Type of Establishment: Single Family x, Multi Family <br /> Commercial Garbage Disposal Yes)_ No <br /> No. Potential Bedrooms 5 Est. Gallons Per Day 7 50 <br /> Depth of Sand: Upslope: 1 .1-7 Downslope: 1.7 -7 Soil Sizing Factor 0.43 3 <br /> Perc Rates P-1 1H P-2 11 P-3 13 P-4 1\ P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 a6" B-2 aa" B-3 3o" B-4 30" B-5 B-6 <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 W/Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size 130 0 # of Tanks a Lift Tank Size 130D <br /> Pump Brand GPM 3S. 3 Head 14. <br /> Treatment System: <br /> Minimum�o x 63)(41 ( $�) Square Feet with inches of rock below pipe <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'of tested drainfield sites ever. <br /> ACCEPTED_ DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: gfi -,,0 . otet) <br /> pCeSs�{C d',STr:bJ�:e��. 3Yt 4et So'.1 ojy <br /> By: k\om" I Axiom A/,�,�,.- I-a9-Da <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 - Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />