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SEPTIC SYSTEM APPROVAL <br /> � � t � O ORON <br /> 0 C�P� <br /> � � <br /> 0 0 <br /> CITY of ORONO <br /> ,� ,a�:�r,��,. �. <br /> l5� Municipal Offices <br /> � "" ti <br /> �.t� ¢.�G Street Address: Mailing Add�ess: <br /> �C'EggO 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �hr�S Ac�ey Phone (Home)`�Sa-4�d-36oS(Work) <br /> Address �i�ao (3avs�d� Qd CityMGple Plq;r. State t�ni Zip 55359 <br /> � <br /> Site Evaluator 5�,e�1��� State License # 3q $ Phone# yya- 5$5S <br /> Type of Establishment: Single Family �C Multi Family <br /> Commercial Garbage Disposal Yes�_ No <br /> No. Potential Bedrooms �-► Est. Gallons Per Day 6o U <br /> Water Meter Required: Yes_ No x Soil Sizing Factor . � 3 <br /> Perc Rates P-1 a O P-2 a3 P-3 a o P-4 a 7 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 IS " B-2 I6" B-3 �5 " B-4 ►6`� B-5 B-6 <br /> Type of Treatment System: <br /> Standard X Experimental Alternative <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 l000 , ►o�� # of Tanks a Lift Z'ank Size IOoo <br /> Pump Brand GPM 3 �f Head 16 <br /> Treatment System: <br /> Minimum �v x S�, (4l x >5� Square Feet with 9 inches of rock below pipe <br /> Type of covering Fabric�_ Other <br /> TffiS 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 lnspections 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 X DENIED By the City of Orono subject to existing regulations and <br /> thefollowingconditions: PuM d- crv e ;St � fiq�KS, �o not ��- S�M P�m(� <br /> wq`t�� `��o ne�- �o���, VQf�q�� G�a�'re 4or wc5-r s',deyq� Setback o� io �eet. <br /> By: �,� �- s-o � <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />