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r CITY OF ORONO SEPTIC SYSTEM DESIGN PROPOSAL 6 STANDARD REPORT FORM NOTE: This form must be completed by the applicant or his agent and submitted for approval with all re- quired attachments when building permit is applied for. The following exhibits are required as a part of this application and shall be attached hereto: Percolation Test Logs and Soil Boring Logs (on standard forms); Site Plan drawn to scale showing locations of existing and proposed buildings, lot lines, perco- lation test and soil boring hole locations, proposed system location and layout, and well location. THE HOUSE AND DRAINFIELD AREA MUST BE STAKED. Improper or inadequate soil testing or information will result in delays in processing. Permits will be issued only to contractors holding'a current Orono Septic Sys- tem Installers License. TYPE OF WORK: sXNEW CONSTRUCTION ❑ADDITION OR REPAIR ❑SUBDIVISION APPROVAL ONLY PINS NUMBER ✓ ' I ig "2:J 51 COII PROPERTY ADDRESS 2105 OLZZ PROPERTY DESCRIPTION LOT 1 CLA•I R—F— /s"b-L OWNER '5&c-r:Z K. 60Q.6m ITN to 17 F-.,, �A 4�5-300 1�,."ame Mail Address —Lity one SITE EVALUATOR K-),iZK ' 6Fa 01•)54= �A0ZA 1 J�? ,♦` �(F, LAKE 475J 4141 ame��f MailAddress ty hone GENERAL CONTRACTOR 0 Y`�N P—IP, ame Mail Address City Phone SYSTEM INSTALLER (IF KNOWN) NO KNOWN 4T -TW It) TiMF- ame one THE INFORMATION BELOW MUST BE FILLED IN BASED ON THE SITE EVALUATION AND DESIGN REPORT (ATTACH). 1. SITE EVALUATION / DESIGN CRITERIA USED NO. OF BEDROOMS GALLONS PER DAY PERC RATE_�� MINUTES PER INCH INDICATED DEPTH TO SEASONAL WATER TABLE OR SATURATED ZONE INCHES 2. SEPTIC TANKS TANK u 1 /CrC�'"Q GAL. MIN, LIQUID CAPACITY MANHOLE TO 6-12" BELOW FINAL GRADE, INLET AND "- OUTLET INSPECTION PIPES TO SURFACE REQUIRED ON TANK # 2 V U V GAL, MIN, LIQUID CAPACITY ALL SEPTIC TANKS. 3. PUMP STATION XJOT REQUIRED ❑REQUIRED GAL. MIN. CAPACITY (TO ALLOW FOR I DAY STORAGE CAPACITY) ❑SEWAGE EJECTOR (BEFORE SEPTIC TANKS) ❑EFFLUENT ONLY (AFTER SEPTIC TANKS) CHECK VALVE TO BE USED ❑YES ❑NO HIGH WATER ALARM AND MANHOLE TO SURFACE REQUIRED ON ALL PUMP STATIONS. DRAINFIELD SYSTEM MTRENCHES ❑PRESSURE DISTRIBUTION MOUND ❑OTHER: ATTACH INFORMATION TRENCHES: ❑DISTRIBUTION BOX ROP BOXES SQ. FT. BOTTOM AREA TRENCH WIDTH (3' MAX.) FT. CENTER-TO-CENTER TRENCH SPACING-7, 1 FT. 1'KIN U DEPTH OF ROCK BELOW TILE (6" MIN.) INCHES DEPTH OF ROCK OVER TILE (2" MIN.) INCHES DEPTH OF TRENCH BELOW ORIGINAL SURFACE INCHES FINAL COVER(H" MIN.,24" MAX.) INCHES NUMBER OF LINES_�� LENGTH OF EACH LINE c-0 PRESSURE DISTRIBUTION MOUND: ❑STANDARD DESIGN AS PER ORONO DESIGN IIANUAL ❑OTHER SAND BASE DIMENSIONS: LENGTH FT. X T. WIDTH SAND DEPTH BELOW ROCK INCHES ROCK BED DIMENSIONS: STANDARD 10 FT. WIDTH X FT. LENGTH SLOPE AT SITE Z FOR OFFICE USE ONLY ❑APPROVED AS PROPOSED�PPROVED ❑ADDITIONAL ITEMS NEEDED NOTED BELOW �1 S I�l�Gl L L k'� /N f'+�`k� M'�'� `� y2o►��8�� C, D��S/G-� APPROVED BY: ATE — 3 _