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SEPTIC SYSTEM APPROVAL <br /> lik) 0 41* <br /> INS p 7831C TOR 7S : <br /> tg <br /> : .,_ CITY of ORONO <br /> !* !S� !, Municipal Offices <br /> '� <br /> �� • <br /> � Street Address: Mailing Address: <br /> 4� <br /> $EgK2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> Owner P"ci o�,Q_ Ne.,.tor. Phone (Home) (Work) <br /> Address So S o( Part. City State Zip <br /> Site Evaluator 5'sc4 c Sct -,r,,,) State License # 6).7 Phone# 7b)-447--S G( <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial Garbage Disposal Yes No <br /> No. Potential Bedrooms 4 Est. Gallons Per Day 6 O d <br /> Water Meter Required: Yes_ No X Soil Sizing Factor 0. 3 <br /> Perc Rates P-1 1-).\ P-2 i`l .s P-3 7.I P-4 1 .'6 P-5 P-6 P-7 <br /> Restricting Layer Depth B-1 (IV` B-2 ..)4" B-3 ao" B-4 24" B-5 DA." B-6 " <br /> Type of Treatment System: <br /> Standard X Experimental Alternative <br /> Pressurized Mound System 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 10 00 # of Tanks a Lift Tank Size /660 <br /> Pump Brand GPM 40 Head as <br /> Treatment System: <br /> Minimum <i ox SC)(44 x I 0'3) Square Feet with C 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: 50\4 lay - acPr,.s I.a - D..O ' - C- exPa 'S-p <br /> 5 <br /> By: %\ 11-15-o \ <br /> Matt Bolterman, On-Site Systems Manager Date <br /> Telephone(952)249-4600 • Fax(952)249-4616 <br /> www.ci.orono.mn.us <br />