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SEPTIC SYSTEM APPROVAL <br />ORONOCOPY <br />T> <br />ClTYoTORONO <br />Municipal Offices <br />StTHt Addrist: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />MaWnf Ad*ns: <br />P.O. Box 66 <br />Crystal Bay. MN 55323-0066 <br />Owner Phone (Home) <br />Address iJ City Occr>Q <br />(Work). <br />State Zip <br />Site Evaluator iCttiv State License Phone# "TCS ~ 26 >7 <br />TvneofEstablisliment: Single Family V---- Multi Family. <br />St. Gallons Per Day. <br />P€:_ <br />Soil Sizing Factor f« C ^ <br />Perc Rates P-1 P-2 liA P-3iSA P-5 P-6 P-7 <br />B-5 B-6Restricting Layer Depth B-1 i.l B-2 B-3 B-4 <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. <br />Holding Tank W/ Alarm_ <br />Septic Tank Size <br />Pump Brand__________ <br /># of Tanks <br />GPM LtO <br />Pressurized Bed System Xf <br />^ Lift Tank Size (^cO <br />Head <br />Treatment System: <br />Minimum *7 5*0 Square Feet with C inches of rock below pipe <br />■Mound Bed 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 e.xcavation 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 S/ DENIED______By the City ofOrono subject to existing regulations and <br />;he following conditions:__________________________________________________ <br />- Vieo 5*A\\ <br />0 vir <br />$;V«. <br />«\\\ ~V^/jV-r S -V. , <br />C-17-01. <br />Matt Bolterman, On-Site Systems Manager Date <br />'Rkpiume (952) 249-4600 • Fu (952) 249-4616 <br />www.ci.oronoann.us i