HomeMy WebLinkAbout2001-P01464 - new septic PERMIT
CITY �F ORONO Permit ►vumber:
2750 nelley Parkway - PO Box 66 Po4164
Crystal Bay, Minnesota 55323 Permit Type: sept��
(952) 249-4600 Date Issued: ioisi2ool
SITE ADDRESS: 2690 Rainey Rd
Wayzata,MN 55391
PID: 04-117-23-43-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Septic Permit Sub-type(s): New 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: Swedlund Septic OWNER: Mr.&Mrs. Ducharme
9520 Laketown Rd 2690 Rainey Rd
Chaska, MN 55318 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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�,A/PPL CANT P E`S NATURE I3SUED Y SIGNATURE
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Copies: 1-File(SiQnitures Reauired). 1-Applicant. 1-Monthlv Reoorts. 1-Assessine, 1-Finance Page 1
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CTTY OF ORONO � ���� SEP'TIC SYSTE�I PERi`IIT APPLICATION
Bos 66 (2750 Kelley Parkway) �l �
Crystal Bay,1�In 5�323 i
__JOB SITE ADDRESS ���9� �1��//VC /�.1� •
Occupancy Type: Residential�_ Commercial �, O
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Permit Type: Ne�v or Replacement System �100.00 �!���
Repair Esisting System .00 � ��,- �'�
(Tanks or Drainfield) `
$0.50 State surcharge added to above fees `,�
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* See fee schedule for non-residential permit fees c � ?�
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O�mer's i�'ame: C��D Lj �V��,�D�'Y�.. Phone Number: '�� �
Mailin Address: City: Zip� � � d�
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Contractor's Name: . u.� .D S 77 C Phone Number: �� , �
N l a i l i ng A d d r�s s: ��'"���D ,Z-�-,�`�7 7�1�.c) � Ci t y: C��-�/<A' Zi r: �jr�%� �,
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*** DO l�'OT IIAIL PAYtI�IENT`ti'ITH THIS APPLICATIOi�T*** '+�'° �
GE1�'ERAL INSTRUCTIONS J,,�
l. 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. - �
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2. Permits �vill be issued only to contractors holding a Minnesota Pollution Control .
A�ency(1�TPCA) Septic System Installers License. �1�
3. All�vork must be done in accordance�vith the approved septic system desijn. Design reports � �'
are not considered approved unless accompanied by the "City of Orono Septic System +��
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Approval" cover sheet si�ned by the City Inspector. s �°�
4. The follo�vin� inspections �vill be required for all septic systems: ���
A Pre-installation site inspection to include inspector, installer, an�i general contractor.
B. Tank installation prior to coverin�.
C. Drainfield trench installation prior to covering. For mounds, inspection is required after
roujh up but prior to sand placement (sand will be jar tested for silt content), and a?ain
durin� pressure distribution pipin� installation in the rock bed.
D. Final inspection to verify proper final cover depths and to verify that all pump stations
(w•here required) components are functional and comply with codes.
5. Individual holding�IPCAInstallers License shall be present durin�all inspections. A 24-hour
notice is required for all inspections.
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NOTE: Applicant must i.nitial all spaces. Fill in all appropriate blanks and check all appropriate
boxes.
_ 1. I have received a copy of the system design i.ncluding the City of Orono Septic
System Approval Cover Sheet.
2. I�vill be installing the following:
A Tanks: X Precast Concrete Other Manufacturer
Tank Capacities: 1) ,�gal. 2) /p p D gal 3)_ gal �
B. Pump Station(if required)
Pump make&model (attach pump curve&
literature); system design requires gpm at feet of head.
Hi�h water 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 5� '
Drop Boxes Sand bed dimensions 36 ' x�� '
Distribution Box Pressure Dist. Pipe Diam. a "
Manifold Pipe Diam. a "
D. Final Cover/Topsoil to be: bono�ved from site
(show location on site plan)
_� trucked in
The undersigned hereby applies to the City of Orono for issuance ofa septic system installationpermit,
a�rees to do all work in strict accordance with ordinances of the City and the regulations of the State
of Minnesota,and certifies that all s tements made on this application are complete,true and conect.
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SignatureofApplicant � Date: 7��4'��
NIPCA License No. �9�
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Staff Revie�y: Approval Denia] �
Reviewer: �Ob� Date• ��3� -a I
Reason for Denial: