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SEPTIC SYSTEM APPROVAL � <br /> r �• ��*�� <br /> �" *;;`'.J <br /> � �� �� �� <br /> O O �,, �.� <br /> ��� <br /> ,� � f�.� �, <br /> CITY of ORONO ��`�� �'� <br /> ti Municipal Offices <br /> � � <br /> �.t9 �.�G Street Address: Mailing Address: <br /> JC'EgKp 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ��r2 P c�-:�c���.� Phone (Home) (Work) <br /> Address �n�S ���N� R � City C�(e?�'�c: State M P�J Zip �S 3�.'� <br /> Site Evaluator�ct t�l st;', State License # �'� Phone# '?63-- �f�y- � �7`i <br /> Type of Establishment: Single Family� Multi Family <br /> Commercial � Est. Gallons Per Day �,�C� <br /> No. Potential Bedrooms s Slope: I `/��� <br /> Depth of Sand: Upslope: 1 Downslope: (� 1 Soil Sizing Factor � •� � <br /> Perc Rates P-1 1�.� P-2 �.y P-3�i: P-4 �`�.� P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 �.1 B-2�•Ck B-3 �-I B-4 �.� B-5�•� B-6 3.i.s <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 Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size 1 SC C'� # of Tanks � Lift Tank Size �S C�? <br /> Pump Brand GPM W 7 Head i 7 <br /> Treatment System: <br /> Minimum Square Feet with � inches of rock below pipe <br /> Mound Bed t 0'� 6a Mound Treatment Area `3'� X�i`� <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 renzain 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 sub�ect to existing reg lations and <br /> the following conditions: — �. � �-��\�S 1�t,� �,e '�•� ��1 <}- c ��,�.e <br /> ._ w �.�� t^��L 5 t-� k,� {e c�u v e.� , � F J ttlf� 5�1t �S �5 e c� , <br /> �- �<f�li �`^�;��� }y� ��y•T � }� �jCG�f< <,r.y cQn�YS�It,U•�. y'"��tS ��ri�Q � <br /> —V�',�;'�RC� 1-� j c, ....�.,r., 1� {t �j- c'� �'a"�1 t`i r.� �..:� CI vC IT) S 1,c�1� C�' <br /> —� � <br /> to;- r�.q) �,t� _ �X.�,�.�, ht:l� ��5 <br /> By: ��-��. ��c,�;�,,,� I�.— �� — C� � <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />