09-15-2021 Septic Design - Laserfiche WebLink

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Preliminary Evaluation Worksheet 1. Contact Information v 04.01.2020 Property Owner/Client: Site Address: Legal Description: Parcel ID: SEC: TWP: RNG: A. Client-Provided Information Project Type: Project Use: Residential use:# Bedrooms: Dwelling Sq.ft.: Unfinished Sq. Ft.: # Adults: # Children: # Teenagers: In-home business (Y/N): If yes, describe: * Clear water source - should not go into system Additional current or future uses: Anticipated non-domestic waste: The above is complete & accurate: B. Designer-determined flow Information Attach additional information as necessary. Design Flow: GPD Anticipated Waste Type: BOD: mg/L TSS mg/L Oil & Grease mg/L 3. Preliminary Site Information A. Water Supply Wells 1 2 3 4 All septic components must be >50' from non-sensitive wells. 131 103 126 #DescriptionMn. ID# Well Depth (ft.) Casing Depth (ft.) 4105 WATERTOWN RD 100158 107 Additional Well Information: 4085 Watertown Rd, Orono, MN 55359 BEG AT INTERSEC OF CTR LINE OF WATERTOWN RD WITH E LINE OF W 10 ACRES OF THAT PART OF E 1/2 OF SE 1/4 LYING E OF W 35 RODS THOF AND SLY OF CTR LINE OF SAID RD AND NLY OF LUCE LINE TRAIL TH S ALONG SAID E LINE 396 FT TH W AT R/A\'S 72.94 FT TH N AT R/A\'S 299.6 FT TH W AT R/A\'S 9.56 FT TH N AT R/A\'S TO CTR LINE OF SAID RD TH SELY ALONG SAID CTR LINE TO BEG EX ROAD 50'4085 WATERTOWN RD 563079 MN Well Index Jake Brown Date Completed: No Water-using devices: (check all that apply) 5/2/2021 2. Flow and General System Information 3111823410005 4 Project ID: 118 2331 Client signature & date 600 <25<60<170 Confining Layer STA Setback 50' Source MN Well Index Residential New Construction Replacement Residential Other Establishment: Garbage Disposal/Grinder Large Bathtub >40 gallons Self-Cleaning Humidifier* Water Softener*Sump Pump* High Eff. Furnace* Hot Tub* Iron Filter* Repair Clothes Washing Machine Sewage pump in basement Other: Dishwasher Expansion