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SEPTIC SYSTEM APPROVAL <br /> � : � 0�0 C - � <br />. � � <br /> ��o 0 <br /> C ITY of ORONO <br /> �,� � �.. � <br /> �r�, � ;�: '�� , �!� % Municipal Offices <br /> \�.� � � �����°�'.��� Street Address: Mailing Address: <br /> V 9�fEggO�'�� 2150 Kelley Parkway P.O. Box 66 <br /> _ " " Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address SIS koke5l. 1-yr-., R� City ��n�o State MN Zip <br /> Site Evaluator Ev o�-� State License # q64 Phone# 763-68a- 'y��7 <br /> Type of Establishment: Single Family �( Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 75v <br /> Water Meter Required: Yes_ No X Soil Sizing Factor �3 �� p <br /> Perc Rates P-1 q P-2 4s P-3 q.s P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 I�" B-2 �o" B-3 �u'� B-4 �a" B-5 1S'' B-6 <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 ISdo, l000 # of Tanks �. Lift Tank Size lood <br /> Pump Brand GPM 66-6 Head I �{ <br /> Treatment System: <br /> Minimum � �ux�5)��15x �o�) Square Feet with � inches of rock below pipe <br /> Type of covering Fabric �� 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 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 /> the following conditions: <br /> By; �a� 10 ���-DI <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />