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. SEPTIC SYSTEM APPROVAL <br /> . '� ��V' <br /> O O <br /> � �, <br /> CITY of ORONO <br /> �', E� Municipal Offices <br /> ti <br /> ��9 .�G Street Address: Mailing Address: <br /> �fEggOg' 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ke��tl� Moy e� Phone (Home)y7b- �3y�! (Work) <br /> Address `a`�10 t���w� R� S . City w�y2����� State M r� Zip 55 �3�i <br /> Site Evaluator Se�-�- 5 W�a1��c� State License# Phone# L-I�)a- S�5 5 <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial Est. Gallons Per Day 6U C <br /> No. Potential Bedrooms '� Slope: I� `'�� <br /> Depth of Sand: Upslope: � ' Downslope: �� i o'' Soil Sizing Factor �. �3 <br /> Perc Rates P-1 P-2 P-3 P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1�' B-2 a.s � B-3 B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard �<, Experimental Alternative Performance <br /> Pressurized Mound System ?< 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 �0 o L� S����� # of Tanks a o�� t�^KS� Lift Tank Size ►UO C.> ��e w� <br /> Pump Brand GPM '37 Head � (, <br /> Treatment System: <br /> Minimum Square Feet with `� inches of rock below pipe <br /> Mound Bed ( 10�x 56� ) Mound Treatment Area (�,8 x � � l � (3 S x s�� ) <br /> � <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�_ DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: <br /> ?� Sewer �-.�� C� dSseS ��ti5 \ :�� _ <br /> � IhG.��Q S �� � �\� ����5 ��� `..,�ttr�:c��.t � Sa�I�S ef �� �1G(� . <br /> �C (�� � '� ��e� `�� n,�o��� S.te �us �O ��� (c�r�Ve �ootS. <br /> By: ��-� �,,���..,� a- a� - 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 />