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� - SEPTIC SYSTEM APPROVALn <br /> . � iJ�� <br /> ND <br /> ��� <br /> � <br /> .� o,� <br /> 0 0 <br /> C ITY of ORONO <br /> ,� � � <br /> �E� Municipal Offices <br /> ��,t .�G Street Address: Mailing Address: <br /> ��ESII�¢ 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner �c�y� - QL I�� �'�`y Phone (Home) (Work) <br /> Address �S 30 �c ;� ST. City C.`f: r,��. State Zip <br /> Site Evaluator �Tc,,, s�t,;rn,cr�State License # 6�7 Phone# 7�3�- y�'i�- �.S E6 <br /> Type of Establishment: Single Family �( Multi Family <br /> Commercial Est. Gallons Per Day ��S C; <br /> No. Potential Bedrooms 5 Slope: � r��ti <br /> Depth of Sand: Upslope: I. C Downslope: I� �' Soil Sizing Factor C�J. Y 3 <br /> Perc Rates P-1 ►� P-2 ��.6 P-3 6 s P-4 �.a P-5 P-6 P-7 <br /> Restricting Layer Depth B-1�." B-2 — B-3� B-4� B-5 11'' B-6 - <br /> Type of Treatment System: <br /> Standard >( Alternative Other Performance <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 1�S� # of Tanks � Lift Tank Size �a�� « <br /> Pump Brand GPM �3 `� Head 3 j <br /> Treatment System: <br /> Minimum Square Feet with �_inches of rock below pipe <br /> Mound Bed 1 l: X 6`� Mound Treatment Area �-{c-� �� _y c:�j� �((�� <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 /> 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 /> - �^�c �`�'� Sc r:� S :tcS .. <br /> , <br /> �— {'Y t�� r�u�r �= �v y' }t j ('�i, ��?- S V�.� (�V�T S �� �'� �G�U n <br /> By: �C� � �-�� -�� <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />