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� , . SEPTIC SYSTEM APPROVAL � � <br /> . ;� �lV' � <br /> , � � ��+��;.� <br /> � O O R�� �� � �� <br /> ' ���-::�' ������-- <br /> '� ='=r � �ITY of ORONO �.� <br /> 'II i'.;�a�j`'�5:�� - � j ��� �` <br /> ' � ., `: 19 <br /> �: r _ t <br /> �, � ��,,� � ���'� ,�t4 � Niunicipal Offices <br /> � � yG <br /> �:� ,�� � � ��?„ �. �:�� � kz��r�, ,�� Street Address: Mailing Address: <br /> $'EggO � 2150 Kelley Parkway P.O. Box 66 <br /> ����� �. -._ticono MN 55356 C stal <br /> . ry Bay, MN 55323-0066 <br /> Owner ����1 T�,or kelSo� Phone (Home)763-5��-�`��(Work) <br /> Address '-4`-t� '��,� Zs 4a�� City O c o�o State Zip <br /> Site Evaluator�oscQ� olSo� State License # 4i 10 Phone# 763- yg$- �6��q <br /> Type of Establishment: Single Family x Multi Family <br /> Commercial Garbage Disposal Yes No�_ <br /> No. Potential Bedrooms a Est. Gallons Per Day 30� <br /> Water Meter Required: Yes_ No�( Soil Sizing Factor p,�b3 <br /> Perc Rates P-1 5.`6 P-2 9.3 P-3 P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 �.5 � B-2 a' B-31.q ' B-4 B-� 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/ Alann <br /> Septic Tank Size IOoO # of Tanks a Lift Tank Size )00 v <br /> Pump Brand GPM_ � � Head � 7 <br /> Treatment System: <br /> Minimum (IT x�5�3y� Square Feet with � inches of rock belo�v pipe <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 NIUST 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 subject to existing regulations and <br /> thefollo�vingconditions: vyr.�„c� ;SS��d +-� 9a �.=�rl•� io' of T�c�-�r I:�cs <br /> G�J To ���o�- I:��S �-u �o 'C�CJJ��, ca�c� easen.��-�- . <br /> By: � oddc �1- 1�. - 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 />