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' SEPTIC SYSTEM APPROVAL <br /> 7 , T <br /> � ._ ���Q �oP� <br /> � �' - <br /> O O <br /> �a r ��., � <br /> CITY of ORONO <br /> !4 Municipal Offices <br /> �� 1 ' G~ Street Address: Mailin Address: <br /> l9 ,¢�, g <br /> kE8TrI0 2150 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner C�� ; 5 MC G f q n� Phone (Home) (Work) <br /> Address a 1 a o �=ox St c e��' City O C o�o State Mnr Zip <br /> Site Evaluator Steve 5�1����e�S State License # (oa7 Phone# 763— t-1q�- 3566 <br /> Type of Establishment: Single Family �X Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms 6 Est. Gallons Per Day �10U <br /> Water Meter Required: Yes_ No X Soil Sizing Factor . �3 <br /> Perc Rates P-1 �►.3 P-2 ��.5 P-3 Io•q P-4 16.o P-5 P-6 P-7 <br /> Restricting Layer Depth B-l�p'' B-2 34'� B-3 34 `' B-4 d��� B-5 aU„ B-6 a4„ <br /> Type of Treatment System: <br /> Standard �( 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 IaSO +i000 # ofTanks o� Lift Tank Size �saU <br /> Pump Brand GPM y a 9 p r� Head I 3� <br /> --r-- <br /> Treatment System: <br /> Minimum (�o x�s) (41x to6) Square Feet with 9 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 ofthe <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' oftested drainfield sites ever. <br /> ACCEPTED >C DENIED By the City ofOrono subject to existing regulations and <br /> thefollowingconditions: OI� fi��Ks rn�5-t �� «�5�.�� <br /> By: ��. 6_y _o � <br /> Matt Bolterman, On-Site Syster�is Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />