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f � <br /> � " �• � SEPTIC SYSTEM APPROVAL <br /> . . ___, <br /> . o �; :,;\ ��0�0 �OPY <br /> � � <br /> 0 0����, <br /> �� , s, �;n !� CITY of ORONO <br /> .� �a��� . -����.- �,; <br /> �, �� ', `�f, , � l�r Municipai Offices <br /> � '�'y' i '� <br /> � 1�i , '�'i„'!;� \�,,ak�'^ G <br /> �,� ,�j� Street Address: Mailing Address: <br /> ��E+gg0g' � 2750 Kelley Parkway P.O. Box 66 � <br /> �__= Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �t�� ����� Phone(Home) (Work) <br /> Address 13�1� (S�1��r ���1� 6.� City �c os`,� State Zip <br /> Site Evaluator Robc�� Kae1. State License# 1 a 3 Phone# ��3 p 4?�_ �637 <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Est. Gallons Per Day <br /> No. Potential Bedrooms � Slope: — <br /> Depth of Sand: Upslope: Downslope: Soil Sizing Factor . � 7 <br /> Perc Rates P-1 �3b� P-2 �,� P-3��,� P-4 1�.�i P-5 1'.� P-6 P-7 <br /> Restricting Layer Depth B-1`�,� B-2 3a� B-3 3e� B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard�_ 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 1��� #of Tanks � Lift Tank Size f��� <br /> Pump Brand GPM 4� Head f�.°Z <br /> Treatment System: /� <br /> Minimum �7�O Square Feet with b inches of rock below pipe <br /> �v4e�Bed �� � �6` 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�_ DENIED By the City of Orono subj ect to existing regulations and <br /> the following conditions: <br /> — �ce S�a� o� r� -�►� o a en��.eS o ee Co�c� <br /> �is• 0�ca- �c , <br /> s �.a�t g�aRZ �1�i-tr n�+�c S>�c. �S �e�a,tclz <br /> `_ J iC,�,01 '3�� s`�1'�S`\��C S " 'V(�`'�! '�' Pt�.T S��4 _ <br /> By: G�� ,(�,�� ��z.7 � � <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-460(1 • Fax(952)249-4616 <br /> www ci.orono.mn.us <br />