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SEPTIC SYSTEM APPROVAL n <br /> RRN <br /> OCOPY <br /> o <br /> (/O a o�� <br /> ! CITYofORONO <br /> A ,tcl4i ,, ,� Ill <br /> � ° ,k 1;' �c Municipal Offices <br /> ` ` t <br /> `4 Street Address: Mailing Address: <br /> AitelAiova 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner 'co M Met M 5 Phone (Home) (Work) <br /> Address 5'0 0 0 c cl.G. NA-k Rd City 0 C 0 cep State Zip <br /> Site Evaluator Sr-‘.4, _ S6,-,c—<(S State License # 617 Phone# Lj 7-SS(,6 <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms '4 Est. Gallons Per Day COO <br /> Water Meter Required: Yes_ No X Soil Sizing Factor 0.53 3 <br /> Perc Rates P-1 63 P-2 7.5 P-3).t{ P-4 °1.S P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 `i." B-2 ac'' B-3 t%I' B-4----(7 B-5 1c6" B-6 116" <br /> Type of Treatment System: <br /> Standard ( Experimental Alternative <br /> Pressurized Mound System ?c 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 000 # of Tanks a. Lift Tank Size 10o O <br /> Pump Brand GPM Head <br /> Treatment System: ,, <br /> Minimum(,1 o)( S 5)(."VV") 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 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: cOos. G*)A---1,-- I b- 1 -0 I <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />