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. . SEPTIC SYSTEM APPROVAL <br />. , � <br /> : on �a <br /> ;;� � � o� a <br /> ,,o 0 <br /> , f;�;.. C ITY of ORONO <br /> .� , � <br /> ` v�,, �� ��, '�� �l5� Municipal Offices <br /> ,� ,, �?,� G /' <br /> ,�9 ¢,� ; Street Address: Mailing Address: <br /> $EggO� 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner Phone (Home) (Work) <br /> Address S7S Kokes�. F�r^• R� _ City d�o�o State M� Zip <br /> Site Evaluator L� otro State License # q 6'1 Phone# �6 3- 6��.- 4�a 7 <br /> Type of Establishment: Single Family_�_ Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms S Est. Gallons Per Day 7 5-U <br /> Water Meter Required: Yes No� Soil Sizing Factor @�� I . � <br /> Perc Rates P-1 � P-2 �S P-3 � P-4 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 ��d'' B-2 �p" B-3 ��-+`' B-4 1�,`' B-5 �S'' 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 "I'ank Size Ipo� � �5�0 # of Tanks � Lift Tank Size IDOU <br /> Pump Brand GPM 66.6 Head ad <br /> Treatment System: <br /> Minimum �ox�5�(�S'� q`� 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'oftested drainfield sites ever. <br /> ACCEPTED � DENIED By the City of Orono subjectto existing regulations and <br /> the following conditions: <br /> By: �a� i o�� -D l <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />