HomeMy WebLinkAbout2001-P03762 - septic repair PERMIT
CITY C�� ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3�62
Crystal Bay, Minnesota 55323 Permit Type: septi�
(952) 249-4600 Date Issued: 6i14i2ooi
SITE ADDRESS: 2150 Prospect Ave
Crystal Bay,MN 55323
P I D: 10-117-23-31-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Septic Permit Sub-type(s): Repair Septic System
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Hayes&Sons Exc. Inc. OWNER: Angela&John Gilmore
263 82nd Street S.E. 2150 Prospect Ave
Montrose,MN 55303 P.O.Box 2150
Crystal Bay, MN 55323
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CI'IY OF ORONO ORDINANCES AND
STATE OF MITINESOTA BUILDING CODE REQUIREMENTS.
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APPLI AN PE [ I NA URE ISSLTEDBYSIGNA -
Copies: City,Applicant,Assessor,Finance Page 1
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CITY O�ORONO SEPTIC SYSTEM PERMTT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay,Mn 55323
JOB SITE ADDRESS �.�` �� � �`�r�`�(F'`�_��
Occupancy Type: Residential `�J Commercial Other
Permit Type: New or Replacement System $100.00
Repair Existing System $ 50.00 ✓'�
(Tanks or Drainfield) �
'y $0.50 State surcharge added to above fees
` * See fee schedule for non-residential permit fees
Owner's Name: J v�h -t��y�� �; 1�^-G=� phone Number•
Mailing Address: ��5 d r��p��t City• v �-�„-.� Zip•
Contractor's Name: �-E��7 -�-�a,-,S ,�`_.�,,,` . Phone Number:��„, - tj'7�-J7(, L
Mailing Address: zc�s �a=� s+� s_� City:/���-t� Zip: s3���.=�
*** DO NOT MAIL PAXMENT WITH THIS APPLICATION***
GENERAL INSTRUCTIONS
1. Applications for septic system permits may be mailed or submitted in person at the City
Offices; however, permits will not be mailed out. The permit must be picked up in person
at the City Offices and work must not begin unless the permit card is on the job site.
2. Pemuts will be issued only to contractors holding a Minnesota Pollution Control
Agency(MPCA) Septic System Installers License.
3. All work must be done in accordance with the approved septic system design. Design reports
are not considered approved unless accompanied by the "City of Orono Septic System
Approval" cover sheet signed by the City Inspector.
4. The following inspections will be required for all septic systems:
A. Pre-installation site inspection to include inspector, installer, and general contractor.
B. Tank installation prior to covering.
C. Drainfield trench installation prior to covering. For mounds, inspection is required after
rough up but prior to sand placement(sand will be jar tested for silt content), and again
during pressure distribution piping installation in the rock bed.
D: Final inspection to verify proper final cover depths and to verify that all pump stations
(where required) components are functional and comply with codes.
5. Individual holding NIPCAInstallers License shall bepresent duringall inspections. A24-hour
notice is required for all inspections.
.
4
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate
boxes.
1. I have received a copy of the system design including the City of Orono Septic
� System Approval Cover Sheet. �
�� 2. I will be '��ias�g th�ollowing:
�
A Tanks: �-i Precast Concrete Other Manufacturer
Tank Capacities: 1) t�al. �) gal 3) gal �
B. Pump Station(if required)
Pump make&model (atta.ch pump curve&
literature); system design requires - gpm at feet of head.
High wa.ter alarm make&model . Outside
electrical work to be completed by installer electrician other.
C. Treatment System:
Trenches: s.f. Mound
Depth of rock below pipe " Rock bed dimensions ' x '
Drop Boxes Sand bed dimensions ' x '
� Distribution Box Pressure Dis� Pipe Diam. "
Manifold Pipe Diam. "
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan)
�trucked in
The undersigned hereby applies to the City of Orono for issuance of a septic system installation permit,
agrees to do all work in strict accordance with ordinances of the City and the regulations of the State
of Minnesota,and certifies that all sta ements ade on this application are complete,tsue and conect.
Signature ofApplicant Date: �Z-o ►
MPCA License No. � �v
Stat�'Review: Approval Denial
Reviewer: ��� Date•� �—�~ � y
Reason for Denial:
�^\�� DATE TIME
CITY OF ORONO CALLED IN '
INSPECTION NOTIC scHEou�Eo = �
PERMITNO. 37�-'Z COMPLETED � i-�0 3(.�.
ADDRESS�l S� ��/�s��.��_
OWNER CONTR. � �e '�"SUl-S
TELEPHONE N0. � � y 7� � 7�v c�
� DESCRIPTION� �i f �h S be • " �f�G�/1��dG1--�'
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
`� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTORTOMEETYOU:�YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
p ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-4600
Owner/Contr,actor on site:
Inspector. �� 1 ���C�,,��., lZ °'�' �.e� n..��.__,
White Copyllnspector's File Canary CopylSite Notice