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SEPTIC SYSTEM APPROVAL <br /> � � :x.- . -,. <br /> � � G l �. <br /> � <br /> O O <br /> � �r� ,T� ,� C ITY of ORONO <br /> "�'i� `����;1��`��:�� ,��' Muniripal Offices <br /> �'� �'� ,�`�s;���' G street Address: <br /> ,¢�i Mailing Address: <br /> �CEggO 2150 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ���;s A�►�ev Phone (Home)9Sa-4�d-3[oS(Work) <br /> Address y�ao (i�ys,de Rd Cityr�,ple PI�;� State M,v Zip Ss3s9 <br /> Site Evaluator 5�.e�1��,� State License # 3q$ Phone# 4ya- 5$55 <br /> Type of Establishment: Single Family �C Multi Family <br /> Commercial Garbage Disposal Yes� No <br /> No. Potential Bedrooms 4 Est. Gallons Per Day bo 0 <br /> Water Meter Required: Yes_ No x Soil Sizing Factor . S 3 <br /> Perc Rates P-1 a O P-2 d3 P-3 a o P-4 a 7 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 is " B-2 �6" B-3 ►S" 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 , �ono # of Tanks a Lift Tank Size IOoo <br /> Pump Brand GPM 3 $ Head I 6 <br /> Treatment System: <br /> Minimum�o xs��4l x >5) Square Feet with 9 inches of rock below pipe <br /> � <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 X DENIED By the City of Orono subject to eacisting regulations and <br /> thefollowingconditions: Pun.p �- crv�ti ex"5-1-�,�q fia�k5 Oo �ot p�fi S�M� Pum(� <br /> wa-tt� `�t�o ne..., r�o���. Var;G�c� q�o.��-�� �or west s�de,rR�d Sc�►-bAck D� �o {�efi_ <br /> By: �'}1'1ax�. 7—S-O l <br /> Matt Bolterman, On-Site Systems Manager Date <br /> � <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> . www.ci.orono.mn.us <br />