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SEPTIC SYSTEM APPROVAL <br /> 0 k. <br /> O O� <br /> CITY of ORONO <br /> Municipal Offices <br /> Street Address: Mailing Address: <br /> 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ��',�h. d c w Phone (Home) (Work) <br /> Address 10 w' t10 D C . S. City O[o r'o State n\t\/ Zip <br /> Site Evaluator Ste,;z State License # 6a? Phone# 7(,-3- LArQ - .35(c <br /> Type of Establishment: Single Family Multi Family <br /> Commercial Est. Gallons Per Day ASO <br /> No. Potential Bedrooms 5 Slope: 6 c'/v <br /> Depth of Sand: Upslope: 1, 4 Downslope: a Soil Sizing Factor <br /> Perc Rates P-1 `d.6 P-2 3.)L P-3 P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 C," B-2 a" B-3 AO B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard '>< Alternative Performance Other <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 tAS 0 # of Tanks Lift Tank Size t�S� <br /> Pump Brand GPM Head 1q <br /> Treatment System: <br /> Minimum Square Feet with inches of rock below pipe <br /> Mound Bed `1 L k Mound Treatment Area 41x "A 0 J�- y i -/L t 10 <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 /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />