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� <br /> � , , <br /> SEPTIC SYSTEM APPROVAL <br /> '� 0� <br /> O O � �� <br /> �� ITY <br /> . ��� <br /> � of ORONO <br /> � <br /> � �.- <br /> �ti Municipal Offices <br /> ��� .�G Street Address: Mailing Address: <br /> 9kEggOg' 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner ��'�+1� �j��1�^,z,,/ Phone (Home) (Work)`����-��1 -�% (�� <br /> Address 3�'r l t=n�' u�,e.-� L2��-�,�c City C��<<�� ,�. State r,�N Zip <br /> Site EvalLiator yi�.<r Sr.i.,�mer� State License # b.�� Phone# �E.,�t --`���7--�5�� <br /> Type of Establishment: Single Family '� Multi Family <br /> Commercial Est. Gallons Per Day `1 C' �' <br /> No. Potential Bedrooms �; Slope: o. `'�C� <br /> Depth of Sand: Upslope: Downslope: Soil Sizing Factor �. � J <br /> Perc Rates P-1 P-2 P-3 P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 7�}�{ B-2 �Y� ' B-3 �� �' B-4 �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 i ��'�� # of Tanks Lift Tank Siz ISC•��� � ��,�IL � <br /> Pump Brand� �,;�.. S �ce�cc�' GPM �; Head 7 ��c�- <br /> Treatment System: �}- �6 1� ���r <br /> Miniinum :�t�'x 7 5 Square Feet with 1 :� 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 excavation and <br /> fencing must remain in place until final site grading. Approval to pour footings will not be granted <br /> u�ltil the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VENICULAR TRAFFIC OF ANY KIND is allowed within 20'oftested drainfield sites ever. <br /> ACCEPTED_�� DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: ,.��f+�,°� ��h''/ rn?:y7- !�;. ;�,5r<;�,;a�. rv,�cc� i���,�_ F��ci nr d c! i-;��,,�- 1����IS , <br /> �X�.,, v�� � _ �=i�� vf :,� �� :��-�.�a�t; o� � � E�.�., s��r ��.. �� T�� <br /> �t.'�'�r �\� Szt}r:� 5 y 5 v�� 'u ��� �v �ro �i �:1 �S � d � bv e t. �, <br /> a �/�J �h.. �� � � 0�... r.,� <br /> C �y wi�\ hcr> t� c;�-.cc.�t�. rar•.���;_h� i� .'� ►��(��r �,.r',�� ;� rn�I< �a:c', <br /> �.�.�• 'M�,1� i�t. �-�'��l��:r., .f .S{�r.� c+�.�iC��'C�i���., 4�:?� .c.�- h���.��1�- - �1�1� C.F �•Jf�� f v�. "t / <br /> �tt', s-- t..i.� n ya �1�-w� �•11' . <br /> By: ��;�,. ���-r.�..� ;� _ :�4i - :`� %� <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />