HomeMy WebLinkAbout2008-P12035 - new septic ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway-PO Box 66 P12035
Crystal Bay, Minnesota 55323 Permit Type: Se ric
(95�) 249-4600 . p
Date Issued: 5/7/2008
SITE ADDRESS: 1940 Sixth Ave N Unit#
Long Lake,MN 55356
P��� 27-118-23-42-0003
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: $ 100.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 100.50
APPLICANT: Advanced Excavating OWNER: Jim&Judy Pierpont
700 O'Brien Parkway 1801 West Farm Road
Belle Plaine,MN 56011 Long Lake,MN 55356
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.
APPLICA , ERMITEE SIGNATURE ISSLTED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�
O,�D�O City of Orono FOR CITY USE-ONLY
P.O.Box 66
: , .,:
2750 Kelley Parkway Date Received:; Permit#
����� Crystal Bay,MN 55323 `:
(952)249-4600 Amount: $ `
CITY OF ORONO - SEPTIC SYSTEM PERMIT APPLICATION
(All permits must be approved by the On-Site Septic Manager and/or Building O�cial)
Site Address: �� �� L— � i � �N �� �j�: �j�
Owner: �� S d-�,�4 Y � �'�'Daril � Mailing Address:
City: �� 1�('J�, f�f V �l �� Zip:
,
Home Phone: Alternate Phone:
Contractor/App.: �,� � �.
,�r. Contact Person: �i� e /'�iv�
Address: �v �7a CaGrvl�,l� I�v �� State License#: � �5�_
,
M � ���� � �
City: Zip: y Expiration Date: ��'�-�
Phone: �o!Z-3��`�3��/ Alternate Phone: � ����5�_����1
�Residential ❑ Commercial ❑ Other
New or Replacement System $100.00 `�a� ��',
Repair Existing System 50.00
(Tanks or Drainfield)
State Surcharge .50 .50
Total �
V:\(Permits)\Septic System Permit Application.doc
1 / 2
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I will be installing the following:
Tanks
❑ Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other
(list manufacturer)
Number of Tanks:
Size of Tanks:
Treatment System
Trenches s.f.
Mound s.f.
Gravel less s.f.
Chamber s.f.
Final Cover/ Top Soil
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 septie system
installation permit, agrees to do all the work in strict accordance with ordinances of the City
and regulations of the State of Minnesota and certifies that all statements made on this
application are complete, true and correct.
Signature of Applicant Date: � � ���
MPCA License Na: � ����
� �
Staff Review: � Accept ❑ Denied
Reviewer: ,e�� Date: �—7 O�
Reason for Denial:
Comments (to be printed on inspection card):
V:\(Permits)\Sep6c System Permit Application.doc
2 � 2
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C���F ORONO
SERVICES
Swedlund Septic Services, Inc.
CITY�F nR4N4 �PErc Test
SEPTIC PERMI N E Vff
SPFCTOR , ,,a,����1_��,��_
D T - PERMIT NO.�,,,,,,r,,,, � Soil Boring
APPROVF.D 9 SI:Ii�tITTED
APPROVED WITH CORRF:CTION9 AS A'OTE9 •
NOTAPPROVED-CORRECT&RESiiBNIT � DeS1gI1 .",����J l S'� �
Th�sc commcrt�are fot your informaticn. All wwk ahali be don�1
1n uli compliancc with eQ applicablo septio�nd soning cude.
Rc�uiremcnts including items not speciticslly notcd ia lbis revierr. ❑ Instal lation Estimate
K[[iP TH1S PLAN S6T ON StTE AT ALL T1MES
Prepared For:
�
O�rNIQS c� �v �et ���1�
19 �0 � �= f�Ue N.
C2,Yorio � YYI JV SS�.S�o
9S� - yia - 00 8` 3
- ��sa - ��Is- �t,�l3
Site Address:
�YLt�
,
25648 200th Street • Belle Plaine, MN 56011 • 952-873-3292
System Speci�cations
Pump Tank:
• A 2.5 inch electrical conduit is to be used for the pump cords
• The piping is to accessible from ground level for future repair
• The supply line leaving the tank is to be sleeved over any
excavated ground in 4" sch 40 PVC and sealed with a 4x2 Fernco
• The floats are to be installed on a float tree
• The pump must be placed on a pump block
• A minimum of a 1/4" drainback hole must be drilled in the supply
line to avoid freezing
Due to the depth of the septic tanks (8' deep) reinforced tanks will be
required
60' feet of 2" insulated PVC is to be run under the driveway
An "Effluent Filter" is to be installed in the outlet of the second tank. It
should be easily accessible from the ground surface for cleaning. The
effluent filter will be equipped with an alarm.
All run-off water is to be diverted away from the tanks and drainfield
areas
Plastic bolt down manhole covers are to be used and left at grade level
for maintenance access.
Pressure rate glue joint fittings must be used.
If the septic tanks are less than 3' deep the covers are to be insulated
with 2" hi�h-density foam
. . �5--4- � �S �
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Swedlund Septic Services, Inc.
� � 25648-200"' Street• Belle Plaine, MN 56011
952-873-3292
Josh J. Swedlund Lic. #2502
* Date:
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ORONO COPY � �PR j 2 �
SERVICES ���oF p �0�
�Oao
Swedlund Septic Services, Inc.
�Perc Test CITY OF nRONO
SFP1"IC P R I P A1V R VIE �V
I�ISPECTOR.����.,�,�i..`
� Soil Boring DAT - PERMIT NO.
APPROV6D AS 3CR�tITTfD
APPROVi:p WITN CORRF•.CTiO�S AS KnTF.(�
� Design NOT APPROVEI�CORRECT 8t R(:St;R�11T
Thcsc commenb aro far your informution. All work shull hc�iuuc
in t'uN compliance with all upplicublc scptic und.anin�:����i�.
0 I11Sta11at10I1 ESt1YIYR�nments including items not specilicnily nnt���:i�i�iui,r��i�w.
K6GP THIS PLAN SET Ul�3iTG AT ALi.T1�1I.5
Prepared For:
artita.s � �v� �er p���
1� �0 C�t �9ve N.
�2,Yono , rYIIU SS�-s<o
9s�- yia • oog3
Site Address: c r �-'"��� ���'Y
�
CF�Q'�TO COFY
25648 200th Street • Belle Plaine, MN 56011 • 952-873-3292
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SEPTIC SYSTEM DESIGN 3
N
Date � . �
SERVICES
OwnerBuilder � �1
Address 1 q �I� � ��� 1/�, ��, , �1r0l�[�
Site Address �yl/l,�_
Home Phone Work Phone Cell Phone 9��" yl�- ��3
The following information has been compiled for a single family home: '� I�US� U� ��oJ� Vd`v
�1nA1M `r5
Bedrooms�_GPD�n�Garbage Disposal It� Lift Pump in Basement �C7
Septic Tank Capacity Pump Tank Capacity )Dd(�
System Type: Mound Trench _ � -'� �1eva�e�.
Distribution: Gravity Pressure Land Slope � ��
Depth to Restricted Layer �' � Soil sizing factor �'� Perc Rate �
Trench System: Drainfield Size/Sq. Ft. g�,, Lineal Ft. o�70 �
SB2 Number of Laterals Rock(Tons)
Rock Width Max Trench Depth Width
G � rn�et'
Mound System: Rock Bed Sand Layer
Upslope Downslope Sideslope
Sand Depth Topsoil on Site Trucked in
Sand(Tons) Rock(Tons) Topsoil (Tons)
Pump Manufacturer: G��/l�'r I lnl�V1C'1�
Requirements:
GPM Head ��+ �
, a„
Force Main Length o�J�� Diameter
Number of Laterals Length
25648 200th Street • Belle Plaine, MN 56011 • 952-873-3292
Svstem Specifications
1. There may be an issue with maximum tank depth if the existing
plumbing is leaving the house under the footing. If the new tanks
are�going to be buried over 4' deep the cover will need to be
reinforced, approval will have to be given by the inspector, and the
plastic risers will need to be wrapped with smooth plastic.
2. The force main will need to be protected from freezing under the
driveway.
3. The force main may need to be air tested if it passes too close to
the existing well.
An "Effluent Filter" is to be installed in the outlet of the second tank. It
should be easily accessible from the ground surface for cleaning. The
effluent filter will be equipped with an alarm.
All run-off water is to be diverted away from the tanks and drainfield
areas
Plastic bolt down manhole covers are to be used and left at grade level
for maintenance access.
Pressure rate glue joint fittings must be used.
If the septic tanks are less than 3' deep the covers are to be insulated
with 2" hi -densit,y foam
� c�a�1� �s �-
US� �- � � � V�o1vvv�.
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' ' Swedlund Sept�'c Services, Inc.
' 25648-200'�Street•Belle Plaine,MN 56011
952-873-3292
Josh,T. Swedlund Lic.#2502
* Date: � �? d
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` Trench and Bed Worksheet
Al!boxed rectangles must be entered,fhe rest will be calculated.
1. AVERAGE DESIGN FLOW ��: ���p�����pa
A. Estimated 600 gpd(see figure A-1) er a
or measured x 1.5(safety factor) = 0 gpd � �� �� ���� �ry
B. Septic tank capa�ity 2000 gallons 2 3� 225 1� 60%
3 450 � 218 of ihe
C•1: S� k Tenk C uitl� in � 4 6� 375 25b vok,es
5 150 �0 294 in ihe
Vqutd qpacity 6 900 52s 332 Go�l
Numher of Minimnm Iiquid �quid capacity with 7 1050 600 370 M.w ql
Bedraoms Capaaty g����� wlth disposal&c 8 1200 675 �e cokxrr�
lift inside
2 or less 750 1125 1�
3 ar 4 1000 1500 � n-15: s�t cc,�r���,a�s�
5 or 6 150Q 2250 3� Pga��ss�(>s����
7,8 ot 9 2IX)D 3000 ��x�� saa s��
mbwba per indi So�'�ad�as squue 6eetlgalbn
da ftT 1
fas6ec than dY Cb�eise sand QB3
Qi bo 5 Medlum sand QBS
2. SOILS(Site evaluation data) a�e�,s� ��,a`d �.�
C. Depth to restricting layer= 4.1 feet �°o� �r�°"" L.z�
166�SO Lomn t.b7
D. Ma�umum depth of s stem Item C-3 ft= 1.1 feet �°o� �i,�°'a" 2m
E. Texture Loam °b6o� ���, �2°
Percolation rate 16-30 MPI a,,,Q��,la�,.. a� �zo
F. SSF 1.67 fi�/gpd(see figure D-15) �i�d�y`''Y
G. 96 Land slope 3 °� 9�"'�`�'"'�
poe�ieure�eutbud�on or ser��dlstdbunanw¢n
9o►1�h8 J�5o9i or�m�aa�6$�a�d pl�vety Hna a
3. TRENCH OR BED BOTTOM AREA �Rmau `�mu9tbe u�aa,
H. For trenches with 6 inches of rock below the pipe: `"•�►n ocn�r o�s�,rna�9y�c�m�st�e u�
A x F= 600 gpd x 1.67 ft/gpd = 1002.0 ft�
I. For trenches with 12 inches of rock below the pipe:
A x F x 0.8= 600 gpd x 1.67 ft/gpd x 0.8 = 801.6 ft
J. For trenches with 18 inches of rock below the pipe:
A x F x 0.66= 600 gpd x 1.67 ft/gpd x 0,66= 661.3 ft
K. For trenches with 24 inches of rock below the pipe:
A x F x 0.6= 600 gpd x 1.67 • ff/gpd x 0.6= 601.2 ft2
L. For gravity beds with 6 or 12 inches of rock below the pipe;
1.5 x A x F=1.5 x 600 gpd x 1.67 fUgpd = 1503.0 ft
For pressure beds with 6 or 12 inches of rock below the pipe;
A x F= 600 gpd x 1.67 ft/gpd = 1002.0 ft
4. DISTRIBUTION(Check all that apply)
Bed(<6°�slope) Drop Boxes(any slope) Rock
Yes Drop Boxes(any slope) Distribution Box(<3%) Yes Chamber
Pressure Gravity Gravelless
5. SYSTEM WIDTH,LENGTH AND VOLUME
M. Select width= Q ft
N. If using rodc,divide bottom area by width:(H,I,J or K)divided by P=lineal feet
�ft2 / 0,0 ft = #VALUE! lineal feet
Rock depth below distribution pipe plus 0.5 foot 6mes bottom area:
(Rodc depth+0.5 foot x Area(H, I,J,K,L)
( ft+0.5 ft)x � ft� _ #VALUE! ft3
Volume in cubic yards=volume in cubic feet divided by 27
#VALUE! / 27= � yd3
Weight of rock in tons=cubic yards times 1.4
#VALUE! x 1.4= � tons
0. If using 10"Gravelless Pipe,length=Flow A x Gravelless SSF(see figure D-9)
600.0 gpd x � ff/gpd = 0.0 lineal feet
P. If using a Chamber H, I,J,K@ased on height of chamber slats]divided by width of chamber in ft)
801.6 ft/ 3.0 ft = 267.2 lineal feet ,
n.�: s«t c���.rxs�a sou.u„g
r,n«.css��c�na..r��
minu�iin�dU �a1�baxture �irn�
Fasler tN�Qf• Caaree Swd
Qt to5 Medlum Sw�d 0.26
0.7105 HneSirW� 0.6
6to15 Sar�dyLoem Q�2
31605 �k Laem Q67
�b to60 Qay L_aam(CL) 0.71
�5f1(tlyy�C�
�avar Fhm 60'• C7ay ---
5emdy Llay
SYlty Qay
•ShctmmrraefQsawa�e tm�ma�t
Ux rytaru Iv rapidry���e adla
"Sail havf SO'L Q tt+Qe tine�nd tvay Nne as�d
•••Shc wttfi�m Mgh a paroadsge d day fv
In#atlatirn d a ls�tlsd Ingeaund aylan
7. LAWN AREA
Q. Select trench spacing,center to center= Ofeet
R. Multiply trench spaang by lineal feet R x�=sq.ft.of lawn area
0 x � _ #VALUE! ft
8. LAYOUT
Select an appropriate scale;one inch= Ofeet
Show pertinent property boundaries,rights-of-way,easements.
Show location of house,garage,driveway,and all other improvements,existlng or proposed.
Show location and layout of sewage treatment system,well and dimensions of all elevations,setbacks and separation distances.
I hereby 'fy I e co leted this wo�C in accordance with all applicable ordinances,rules a la
nature) v��(license#) 7(date)
' , ,
DOSING CHAMBER SIZING
All bozed rectangles must be enfered,the rest wiB be ca�ulated. Width
1. Detertnine area
A. Rectangle area=L x W
� ft x, �ft = 0 it� Length
B. Circle area=3.14 x radius2
3.t4 x ZR = 0.0 it�
C. Get area from manufacture it� Radiu
2. Calculate galbns per inch
There are 7.5 gallons per cubic foot of volume,therefore multiply the area(1A,B or C)
times the conversion factor and divide by 12 inches per foot to calculate gallon per inch.
Surface area x 7.5I 12= 0� x 7.5 I 12in/ft = 21 gallon per inch Legal Tank:
500 gallons or
3. Calculate total tank volume 100%the daily flOw
A. Depth from bottom of inlet pipe to tank bottom 47 in or Alternating Pumps
B. Total tank volume=depth from bottom of inlet pipe to tank bottom(3A)x ga�n(2) ,��:�s���c�a«.p.,o�,,, '
= 47 in x 21 gal�n = 987.0 gallons �n �, �„�� �u� aa.�v
4. Calculate gallons to cover pump(with 2-3 inches of water covering pump) � � � z8e �r�`,►,.
(Pump and block hei ht+2 inches)x gallon per inch s � � � �
( 12 + 2inj x 21 galfin = 294.0 gallons a 900 �s xs� a°"�
7 1050 600 S70 M.w III
8 1200 675 �l04 eduns.
5. Ca�ulate total pumpout volume
A. Select ump size for 45 doses r day. Gallon per dose=gpd(see F'�gure A-1)/doses per day=
�P1 gpd / �doseslday = 150 galbns
B. Calculate drainbadc
1. Determine total pipe length 250.0 ft �
2. DeteRnine liquid volume of pipe, 0.17 gaVft(see figure E-20)
3. Drainbadc quanfity= 250.0 ft(561) x 0.17 gaUft(562) 42.5 y ��� Volume of Li uid in Pi
C. Total pump out volume=dose volume(5A)+drainback(5B3) I'ipe Diameter Gallons per foot
150 galbns+ 42.5 gallons= 192.5 1 0.045
125 0.078
6. Calculate float separaGon distance(using total pumpout volume) 1.5 0.11
2 0.17
Total pumpout volume(5C)I gaUnch(2) 2.5 025
192.5 gal I 21 ga�n = 9.2 inch 4 0.�
7. Calculate volume for alarm(typically 2-3 inches
Alartn depth(inch) x gallon�nch(2) = 3 in x 21 g�n = 63 gal
8. Ca�ulate total gallons=gallons over pump(4)+gallons pumpout(5C)+gallons alarm(7)
294.0 gai + 192.5 gal + 63 gal = 549.5 gal
9. Total tank depth=total gallons(8)I gallonCn(2)� � h
549.5 gallons I 21 gaUn = 26.2 p� � ` `€
eeenre cvpvcii
� olann on
� ` oonlid
------- -
Ca�u ate reserve capaaty(75%of the daily flow) P�I�ut va�ine� €� p�-,p on
Dai flow x 0.75 = 600 x 0.75= 450 allons � p ont a �� contra
€
I hereb 'fy th hav co ted this w�ork in aoc�rdance with all applicable ordinances,rules and laws
(signature) �sO� picense#) (date)
. � • '
. PUMP SELECTION PROCEDURE
All boxed recfangles must be entered,the rest will be calculated.
1. Determine pump capacity:
A. Gravky Dlatribution
1.Minimum required discharge is 10 gpm
2.Maximum suggested discharge is 45 gpm
For other establishments at least 10�greater than the water
supply rate,but np faste�than the rate at which effluent will flow
out of the distribution device.
B. Pressure Distribution-see pressure design worksheet S°°he°f'r'er't svsfer"
&p f I harge
Selected Pump Capaclty: �gpm totai p�pe
len
2A,elevaflon
Inlet dliference
2. Determine head requirements: dr�
----�-- -- -
A. Elevation difference between pump and point of discharge, -----_�---�-�� -
16 feet ....--•.................... .......
B, Special head requirement?(See F'�gure-Speclal Head Requirements) >
�feet Speaal Head Requirements
Gravity Distribution Oft
C. Friction loss Pressure Distribution 5ft
1. Select pipe diameter �2 in
2. Enter Figure E-9 with gpm(1A�B)and pipe diameter(C1)
Read�iction loss in feet 100 feet from Figure E-9 " � ���� c��
Friction loss= 1.55 ff/100 ft of pipe ����
nornfnoi
pipe dame�Mat
3.Determine total pipe length from pump discharge to sal system discharge point. �+� �•5' �� ��
Estimate by�ding 25 percent to pipe length for fitting loss.
E uivalent i length times 1.25=total pipe length � 2.47 0.73 0.11
250 ft x 1.25= 312,5 feet
30 5.23 1.55 0.23
4.Calculate total fiction loss by multiplying friction loss(C2) 35 6.96 2.06 0.30
by the equivalent pipe length(C3)and divide by 100.
FL= 1.55 ft/100h X 312.5 ft I 100= 4.8 feet 45 11.07 3,28 0.48
50 13.46 3,49 0.58
D. Total head requirement is the sum of elevation difference(A),special � 5.60 0.82
head requirements(B),and total frictlon loss(C4).
16 ft + 5 ft + 4,8 ft 65 6.48 0.95
70 7.44 1.09
Total Head: 25.8 feet
3. Pump Selection �
1.A pump must be selected to deliver at least 30 gpm(1A or B)
with at least 25.8 feet of total he� 2D,
I hereby ce 'fy that I have pl this wo�C in aocordance with all applicable ordinances,rules and laws.
signature) ���O�. (license#) (date)
�
�
`�: .,�"
�,.��
�
--- ` ��e�r LOGS OF SOIL BORINGS �
..._
Location of Project ����a�. cS � �
� 3 a� � .
Bonngs made by JOSH J. SWEDl.UND Date 0
Classification System: ❑ AASHO � USDA-SCS ❑ Unified ❑ Other
Auger used (check two): �Hand ❑ or Power, ❑ Flight �or Bucket; [] Other
Depth,- Boring Number a- Depth, , Boring Number �
in feet Surface Elevation in feet Surtace Elevation
o v `�'�` o �� ,
�� � � L oaW`-
�" �f v�L �oa r✓l.-
1 -
2 - ' YR � 2 -
1 �T �.vµ '(
3 - 3 - � �DQ i'VC�
,• ,
4 4 _ S.o.
„ � s;� ��"-: s��� '� ��J L��
5 - _
6 - . 6 -
7^- ' 7 -
End of boring at �� feet. End of bo�ing at 5 7�' feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. _ hours after boring.
�Not present in boring hole. Not present in boring hole.
MottJed Soil: � �� Mottled SoiL• ��
� Observed at��feet of depth. Observed at��feet of depth.
� ❑ Not present in bo�ng hole. Not present in boring hole.
. ' Dat� � PERC TEST BY JOSH J. SWEDLUND
►
� Location �Q Hole#�_ Depth 1� )
Soil Depth �� Texture �4�m-
Depth of Initial ��
Water Filling
Perc Test starting Time and Date: Time -I � U� Date ! �
Time Intervals Drop in Inches Perc Rate
� �o m � 1' g ��
; ao � ��
q � yo - �
Date PERC TEST BY JOSH J. SWEDLUND
Location Hole# � Depth l� 'r
Soil Depth � " � Texture �A WL •
Depth of Initial �a ��
Water Filling
Perc Test starting Time and Date: Time � � �� Date
Time Intervals Drop in Inches Perc Rate
o� : c� O ,� . 1 �
; �o d 1 �4 /�S
q'� �0 �D �d
Date PERC TEST BY JOSH J. SWEDLUND
Location Hole# Depth
Soil Depth Texture
Depth of Initial
Water Filling
Perc Test starting Time and Date: Time Date
Time Intervals Drop in Inches Perc Rate
CERTIFICATE OF INSPECTION
ACCORDING TO MPCA 7080
ORONO BUILDING & ZONING DEPARTMENT
2750 Kelley Parkway
P.O. Box 66
Crystal Bay, MN 55323
This certificate has been issued this 1 St day of June 2009, to certify compliance with
provisions of the Orono Municipal Code and Minnesota Rules Chapter 7080, regulating
installation of individual sewage treatment systems.
Owner: James Pierpont Site Address: 1940 Sixth Ave N
P.I.D.: 27-118-23-42-0003 Permit #: P12035
Installer: Swedlund Septic Services, Inc.
�� �J t��``c.�
Compliance Officer:��
data/forms/blank cert of inspection MPCA 7080
�L �
�D� TIME
CITY OF ORONO CALLED IN
INSPECTION N E � SCHEDULED �S_l(o�_O8 y;30
PERMIT NO. �� COMPLETED
ADDRESS �I�D �1�Ii� iU '
OWNER CONTR. L�I�UQ.t� '
TELEPHONENO. l>- ��[J� 3997
� DESCRIPTION ���� �� � / v�-��
� ❑ FOOTING ❑ ECHANICAL R� ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a � ` � Cx�O (,--� I l o/J J 14.� KS
� �lb ��?- Ch�'1M. �� S�s�►�
0
� � k -��' �C� �% �v�
� '��1,� ( ( v crJ
Q � e` ` 5 �-(-�3�-c-'e s �l�
Z �:.!... � � � � , ,C'
W �� � -� v �
�
j L� S��a �l� � �5 P� 7Jes ��'�. Se e
��WORK SATISFACTORY:PROCEED �Q S '�!� ❑ PROr JE COMPLETE Ya J�
W ORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 2a hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. � �--� ' / �` �.�..�
White Copyllnspector's File ' Canary Copy/Site Notice