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� SEPTIC SYSTEM APPROVAL � ���� <br /> . � , � R���� �OPY� <br /> . , � � <br /> �- ,�- o;.�, <br /> � � � �, <br /> �o o ��� <br /> � � �� � ''��� CITY of ORONO <br /> ' 1� ,, �j iJ�^ �l j i <br /> � ti MunicipalOffices <br /> "� � ,� ;`. � //', <br /> ��� �� � ���' Street Address: Mailing Address: <br /> �� <br /> ���'9$EggOg'� 2150 Kelley Parkway P.O. Box 66 <br /> \----� Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner `�j� v:� �;'��� -1��-��e; Phone (Home) (Work) �- <br /> Address y:�u S ��1,.����„� L.,,,�� City ����.�� State �� Zip <br /> Site Evaluator �-f Te s+�� State License # c�7 Phone# �6 3 -���� .� -�E�6 <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms � Est. Gallons Per Day �;c <br /> Water Meter Required: Yes_ No � Soil Sizing Factor - `.� � <br /> Perc Rates P-l�,(, P-2 �, , P-3 .�a P-4 ��.S P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 �a" B-2 ._� B-3 ���'' B-4 ,�� ' B-5 ,��f " B-6 �y " <br /> Type of Treatment System: <br /> Standard �C Experimental Alternative <br /> Pressurized Mound System �C 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 ►��-c/ior c� # of Tanks --� Lift Tank Size I�S"C'� <br /> Pump Brand GPM �'� Head 1`;' <br /> Treatment System: <br /> Minimum�►;'�6r5���- yC�'� co4) Square Feet with � inches of rock below pipe <br /> Type of covering Fabric X 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 (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. Appro��al to pour footin�s 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 /> By: v���-�- �:�12..rr�n,�.. <br /> Matt Bolterman, On-Site Systems Manager <br /> ����� <br /> �� <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />