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SEPTIC SYSTEM APPROVAL �� <br /> . ON <br /> .� o.�,. <br /> 0 <br /> COP <br /> � <br /> 0 0 <br /> } ta.� CITY of ORONO <br /> ,a �„ <br /> �,� � ;sw. G�ti MunicipalOffices <br /> Street Address: Mailing Address: <br /> �'`9k'E88Og'� 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner K�� n q 5��.� � M.,r �1�,� Phone (Home) (Work) <br /> -� <br /> Address l 5�;o f-o X S t' City 0 r o �o State M n� Zip 5 S 39 1 <br /> Site Evaluator Sw eJ l„� State License # Phone# y y a- 5 s s 5 <br /> Type of Establishment: Single Family�__ Multi Family <br /> Commercial Garbage Disposal Yes X No <br /> No. Potential Bedrooms y Est. Gallons Per Day 6�0 <br /> Water Meter Required: Yes_ No )( Soil Sizing Factor U. $3 <br /> Perc Rates P-1 1 S P-2 �3 P-3 1y P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 a,5 B-2�' B-3 �'7" B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard Y. Experimental Alternative <br /> Pressurized Mound System x At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/ Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size �o 00 # of Tanks a Lift Tank Size <br /> Pump Brand GPM 3$ Head I 6 <br /> Treatment System: <br /> Minimum ��o x 5 n �3G x �o� Square Feet with 1 inches of rock below pipe <br /> Type of cov`ering Fabric_� Other <br /> THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. <br /> A pernlit inust 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 x DENIED By the City of Orono subject to existing regulations and <br /> thefollowingconditions: p�c -t� fe(�Iqce�.�fi SCp�-;� q�c� o��� Spo� -fi-� Au+- <br /> c�e-w S�P�-� � �a�:e�ce �-� q���w- 1'hou�d '^�;��., � 5� -�Qefi �� `^-CrI°1�� <br /> By: �c�c �- b- a \ <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />