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, - SEPTIC SYSTEM APPROVAL `� �� ,� <br /> -��, � � ���' k ��`'c�; !� <br /> /, � � � �' ��� '� � F; <br /> //� �\ r � '� <br /> �� � ��i <br /> I � <br /> � � �� CITY of ORONO <br /> ,� � '' <br /> � �t��. ;; <br /> ' !� ' Municipal Offices <br /> ` \� c =� <br /> � � ' '��� ��`� G�;'��� Street Address: Mailing Address: <br /> �����`q�f' � � 0��� 2750 Kelley Parkway P.O. Box 66 <br /> �SH�,� <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner -���\�q �re. �`�� �`���`S Phone (Home) (Work) <br /> Address 66`� Fz�� �•t2 �c R✓ City ��tc��G State �N Zip <br /> Site Evaluatar ��-cr ���1�z� State License # �o`� _ Phone# '763- 4�1� 750� <br /> Type of Establishment: Single Family�_ Multi Family <br /> Commercial Est. Gallons Per Day 7 S U <br /> No. Potential Bedrooms 5 Slope: ��U <br /> Depth of Sand: Upslope: 1 Downslope: I �5 Soil Sizing Factor C� .�6 j <br /> Perc Rates P-1 l6 P-2 �3 P-3 iC� P-4 �6 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 3�'' B-2 3�3'� B-3 4`�" B-4 �" B-5 B-6 <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 i�.5� # of Tanks � Lift Tank Size �(�OC) <br /> Pump Brand `�2. I,P bt e��tC� GPM �S Head �� <br /> -T <br /> Treatment System: <br /> Minimum Square Feet with � inches of rock below pipe <br /> Mound Bed �i1�� 63 Mound Treatment Area 3 �� `�?� <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 FENCEI) 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 ,K By�C`ity of Q#�'io subject to existing regulations and <br /> the following conditio�.s; - �a;���.c� . _,�l- �y r^���- !'neet wetl SFr�s`��KS , <br /> 1 `�'� <br /> - t�lc, <�ys�«. ��,��� P� '11;�.i�/ �16s.�e� � <br /> .,�-�s�-+�xr� ���ti � . <br /> -G:S,��. �S �-o� , };M� c���;,nq. <br /> ^ ljDf� S:lk� tr.�St— �� �t�C�C r :c� . <br /> By; ��,-� ���..._. � — �o - �3 <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />