HomeMy WebLinkAbout1991-003957 - drainfield/tank replace PERMIT �
C�IT,�� ' ' "�RONO PERMIT TYPE:
1335 Browr� i� i South • P.O. Box 66 '-��� `t �����'
Permit Number: �?!�����7
'Crystal Bay, Minnesota 55323 Date Issued: `-�-'��i='�-��
(612) 473-7357
SITE ADDRESS: '. ,�tt��r +�~,
:�;�'_���;:� E,�,Y R� t�;
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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LICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
APPLICA'�ON FOR SEPTIC SYSTEM P$RMIT
� � �
CITY OF ORONO
/�s 66 (1335 So BroWn Rd)
Crystal Bay, I�II�i 55323
*****:**�****��**:*****:****:*:#*:*:�**********::***:�*�***�**********::***
General Instructions:
1. You may app� for septic system permits by mail or in person at the
City offices. Howener, permits will not be mailed out and must be
picked np in person at the City offices.
2. Permits are not valid until you receive a permit card.
3. Work must not begin unless the permit card is available on the job
site.
4. Permits will be issued only to contractors holding a City of Orono
Septic System Installer' s License.
5. 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" coner sheet signed by
the City Inspector.
6. 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) Drainf ie ld trench insta 1 lation 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 station (where required) components are
functional and comply with codes.
7. Individual holding MPCA Instal ler Certificate shall be present during
installation. 24-hour notice is required for all inspections.
**#�*,r:�**:�***�::**�*��:**�:*:*�*�::�**:*�*�r*:�r*�::�: * :�:�**�*�:�**:*#**
�— �
JOB SITE ADDRESS: f��� �/G� -�
Occupancy Type: Residential Commercial Other
Owner' s Name:/%�'r"S � �� s/�"���.5' Phone:
Mailing Address: City: Zip:
Septic Contractor' s Name: p��- j, � ,�� Bus. Phone: 7 -� 3G�
Mailing Address: �YS o�-�. n� i��c �"ccl City: �� xt, Zip:,S�S.�s
:**:*�******s*:�*:*�r��*::�r:**: �:*:�****:*t*:��*�:#: **:***:�#�*:*****�*�**
- over -
SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2 ,
�r. .
Permit Type & Fees (check one) 1
� �N � Construction, Full System $75. 00 . .
�Replace Existing System (1 or more new tanks• & •drainfield) . $50 . 00 . . . • . .
Partial Replacement (replace just tanks or just drainfield) $30 . 00 . . .
$0. 50 State surcharge added to above �ermit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT MAIL PAYMENT WITH THIS APPLICATION
****�**********************�**********************�*******�***�************
NOTE: Ap�licant must initial all spaces. Fill in all appropriate blanks,
c eck all appropriate boxes.
I 1
1. I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
2. I will be installing the foli ng:
A. Tanks: �Precast Concrete Other Manufacturer
Tank Capacities: 1 ) ���� gal. 2 ) �����__gal.____3_) _ �l� gal.
B. Pump Station (if r�e ui�e ) .-,��, �(�J�U�� �-"��- '��, �'�
Pump make & modellx-��/�,.��1��`' ,(at�a�h�u�g-ettrve &
literature ) ; system design requires gpm at I�-_ feet
of head. High water alarm make & model ,c � �- °c, � "l-'��' �� .
Outside electrical work to be completed by �installef
electrician other Inside electrical work
must be completed by electrician.
C. Treatment System:
Trenches : s.f. .l Mound
Depth of rock below pipe " Rock bed dimensions ��'x���
Drop Boxes Sand bed dimensions�'x '
Distribution Box Pressure Dist. Pipe Diam.�"
Manifold Pipe Diam. `'i ��'
D. Final Cover/Topsoil to be: borrowed from site
/(show location on site plan)
l 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 the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this app lication
are complete, true and correc .
.,
� �
� � �
Signature of Applicant• /� ,�-�/ Date: ��
MPCA Certification No. : ��� ,
O� � �sSu �
R�2�- q
' ' . _ .-•�. '� Per�it �
,C�IT`± Og ORONO
�- "�' , , : S3PTI� SYSTE�'+S APPROVAL Fee $
�� Z�',, ' y �"
�. � ... � _ � ..._ Entered By
��. , ,
,� �x. . . : �-
The General Contractor will be given a copy of this report and is
responsible for its dist��PROVED IINLESSuTHIS SHEETtISSATTACHEDC SYSTEM
DESIGN IS NOT CONSIDERED
, ' / �" ,{;��
LOCATION: �G�
PHONE:
(',F.NF.RAT CONTRACTOR:
PHONE:
SEPTIC CONTRACTOR:
�' ,���, PHONE:
OWNER: •
❑ APPROVED
�CONDITIONALLY APPROVED: (Note Changes Below)
./ , , ��
COMMENTS: ' � ��`�.l ` �
� � / �� �
, r�s
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NOTIC$ T o f NheAlnspector (�73 7357)S Cai 1 forp'ninspe t ions 24 hoursPin Sadvance ave prior
approval.
NOTICE TO GSNSRAL COFTRACTORS: Primary and alternate drainfield sites MIIST be protected
prior to and after system installation to avoid compaction of the natural soil.
T liIISg E3 'F�'�.� �� P=�-�r �O �"�=��'-ng site excavation and fencing must
� ��'�i� � roval to aur �ootin s will not be granted
remain in piace until final site grading. App P
9
unti3. the Inspections Department has verified that primary and alternate sites are
adequately protected.
AO VEHICULAR TRAFFIC OF f�idl�esa either cbeforeror afterg systemeconstructionallThis
within 20' of tested drain
applies to the lot you are working on and all adjacent iots. You could be held liable or
damaging sites on neiqhboring lots.
VSH2CIILAR TRAFFIC CAF CAIIS$ SOIL CO2iPACTIOH, RSNDBRIPG DRAINFIBLD SZTSS UN e��$:
Evidence of traffic on drainfield sites may be cause for revocation of building p
Damaged alternate sites must be rep3.aced before a Certificate of Occupancy will be issued.
�-�'-�- iI � � �� ��'�,
Date Approved By ity of Orono
SYSTEM DESIGN
FOR MRS . PHIL STUBBS� �
ORONO , MINNESOTA � �
� 9- 11 -91 ' .
Information follows on a system design fo�r a pressure mound
system for the Stubbs residence. All construction � and r�.aterials •
must adhere to the provisions of the City of Orono . In addition
to the listed requirements , two septic tanks of 1000 gallons and
a third pumping tank of 1000 gallons are needed for the system.
If any other information is needed , pleas� c'b�tac't_ me .
Sincerely ,
PERCOR , INC .
�''�..��.,��.�-o`"`�d
Mark S . Gronberg
PCA certified
. . .
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� .� � BI�D�l oOr�. E-19
MOUND DESIGN PROCEDURE •�
(For Flows up to 1200 gpd) •
A. Sewage Flow Rate F. Pressure Distribution System
See D-7 or I-3, 4, or 5, or use
metered value; Flow Rate = 1. 5el�ct' number of perforated
l�jrp �pd � later.als 6 " .
2. Select perforation spacin�;
B. Septic Tank Liquid Volume = ,3 ft
(see C-3 or C-5) /Ov0 gallons " .
3. Seiect perforated lateral .
C. Soil Characteristics length; Note if manifold is
at end of rock layer, lateral
1. Depth to restricting layer length is rock layer len�th
- such as seasonally saturated •• �t'ess half a perforation �
soil, bedrock, coarse soil, spacing. If manifold is ii�
etc. ; 2 y inches center of rock layer, lateral,
2. Depth of percolation tests; Iength "is� �one-half rock layer
/.$� inches , length less half a perfarrici��i
' spacing. Perforated lateral
3. Number of percolation test length = /7, 2S ft.
holes; ��j.r holes �,` •
4, D.ivtde later�l lcngth by perfor-
4. Ave. percolation rate; ation spacing to �et nt►mber of
�7. ] mpi perforations per lateral ' '
S. Landslope = � / /7.25 feet = �_feet = 6 per.fs
Nofe: last perforation must be
_ D. Rock Layer Dimensions ' in e�d cap, (see page 1:-14)
1. Multiply gpd by 0.83 to ..5. Multiply perforations per
obtain required area of late.r�.l. b.y'•number oE laterals
rock layer; to get total number of
yS0 gpd x 0.83 = ,37Ssq ft perforations; -
6 perfs/lat x 6 lats = ;3�6
2. Select width of rock layer 6. Determine required flow rate
(10 feet or less) _ /D feet by multiplying numbsr of
3. Length of rock layer = Area perforations by flow per �y �PFf'�
� Width37S sq ft = /p ft ', •• perforation, (see page E-17�
_ .�7.5 ft �perfs x ,7'�Qpm/perf =L6,6�Prn
E. Rock Volume 7. Select minimum required la�eral
diameter from table on Pa�;e E-J.7;
1. Multiply rock area by rock•depth enter table with perforntion �
to get cubic feet. of rock; spacing, perforation diameter,
�7S sq ft x / ft = j7Scu ft and ,nunb'er 'of perforations per
lateral.� Select minimum .
2. Divide cu ft by 27 cu f t/cu yd diameter f or perforated lateral
to get cubi� yards; /,3• 9 � � . .
_ �inches
3. Multiply cubic yards by 1.4 to .
get weight of rock in tons; - G. Basal Width �
/�,9 cu yds x 1.4 � /9,y tons 1. Pezcoiatiotr rate in top 22
inches o.f soil is �7 7 mpi �
2. Selec`t'allowable soil 'lo:adin�;
- rate from table on pa�c� F.-lF,;
O. �O gpd/f t2 .
:
'/ .
�' 3 �F��,�.:�,�^.
,� r•.-2o
/ MOUND DESZGN PROCEDURE ,
(For Flows up to 1200 �P��Continu�d)
G.3. Calculate basal width ratio ' H.2.f. MulCiply. dike multiplicr hy
by dividin� rock layer Z downs.lop�e mound d�eight to ge�
loading rate of 1.20 gpd/ft downslope•"d'zice'�width;
by allowable soil loading y 76X 3,� - �6.2 �t ` �
rate; —
1.20 gpdi f t� = �gpd/f t2 = �, 0 g• Compare the values of step }i. 1
Check this value on page E-16, and sCep 11.2.f. Select tl�e
greater of the two�valuc, as
4. Multiply basal widtti ratio by Clie downslopc dilce wicltli;
rock layer width to get /6• 2 feet .
required basal width; "' �. ,_
2. 0 x /O f t �= 2 p f t h• Calcula'Ce �upsToPe dike wid th
usin� upslope mound hci�ht
H. Do�.�nslope Dike Sdidth and upslope dike multiplier
1. If landslope is 3% or more, -3 y� pag�, -18'��•-� f t
-�L--
i. Total mound width is the sum
subtract rock layer width of upslope dilce widtti plus rocl:
from basal width to obtain layex, �.zidth plus downslope clike
minimum downslope dike toe width width;� �
Zo ft - /O ft = /Q ft /O. ,3 ft + lp ft +/�Zft =,�6, $ft
2. Calculate mound height at edge 3. If landslrs e��is''2,�9 ' '
oi rock layer on downslope side; P Percerie or
less, basal. width i.ncludes betl�
a . Determine d�pth of. �clean sand tlle upslope Zrid downslo1�e clil:c�
i ill at upslope ed�e of rock widtl�s.
layer: /. � feet
b. *fultiply rock layer width by 1�. Calc,i�,l.ate do�anslope dike ea�icleli
landslope to determine drop usin�; steps 11.2.a. Clirc>u1;h
in elevation; i�•2.f; ' �feet ' � •
/. D x � % = 100 = D. �f t b. Calculate upslope dike widtl�
c. Add drop in elevation to depth usin� upslope mound lieigt�t rind
of clean sand at upslope edge dike �mu�-t��lier 'f.�om Pafie �-18;
of rock layer to get dep th of x f t = f t
clean sand at downslope edge , c. Add downslopc dike width to
of rock layer. upslope dike width to rock
O.� f t + /, 0 f t = /. � f t layer wid th to ge l to ta 1 mound •
d. Add depth of clean sand at down- width•. �
slope edge to depth of rock ft�+ ft + [t = [c
layer to depth of soil backfill —'
to get mound •height at downslope �• Compare total mound width �c�
edge of rock layer; required basal widt:h from scep
/�ft +,75 ft +/.1Sft =3.Y ft G.4,. If tot�il mound width is
� greater than requircd basal.
e. Enter table on page E-18 with width, use ca.lculatecl dike
landslope and downslope dike widths. If required 1��;>a.l
ratio. Select dike multipli�r width is �;reater than eoc:�l
of y 7 6 mound width, increase downslope
Y' � f�O�F dike width... �'
i/
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� � G�C L A':��•�
l�-I S
'' YUA1P SEL�CTION PItOCI;DURE
A. Determine pump capacity: ' `� � "" ,
1 . Minimum suggested is 600 gallons per hour (10 �pm) -
to stay ahead of water use rate
2. Maximum suggested for delivery to a drop hox of a liomc
system is. 2700 gallons per hour (45 �pm) to prevent
buildup of. pressure in drop b�x
3. Use value from design o1 pressure distribu•eion system
SELECTED PiJMP CAPACI'I'Y . . . . . . . . . . . . . . .. . _ 2 E. � �;��nl
T3. Determine head requirements: ... "
1 . Elevation dif•ference between pump and poi�it of discharQe � 7 �'`' feet
2. If pumping to a pressure distribution system, add 5 feet
for pressure required at manitold . . . . . . . . . . ,5 [eet
3. Friction loss ---�-----
a. Enter friction loss table with gpm and pipe diameter. ' '
Read friction loss in feet per 100 feet from page F-1R.
F. L. _ � 9 ft/100 ft ' "
b. Determine total pipe length from pump to��,j.�char�e
' point. Add 25 percent to ��ipe len�th for Fittin�;�•
loss, or iise a f LCClllf; loss clicirt. Lqu.ivaleiit �ai�>e
len�th = 1 . 2� times {�ipc len�.�Ch = 1. 25 x Q� - /Up t�,ec
--4----- -- -
c. Ca1cul.aCc� l'oCa] Prictic�n 1���;s by �ui�lfipl.yinf�
fricl'i.on ]05:; In Pt/:1OO ft hy cquiv:�lc�nC ��inc "
lenRth.
'Total friction loss = �, 9 p� •• X' �DD = __ p, } fc�er.
4. Total head required is the sum of elevation difference,
special head requirements, and total friction loss.
7t + $ + 8, 9... , . ,
TOTAL HFAD . . . . . . . . . . . . . . . . . . . . . . ZU. � �
. fc��t
C. Pump selection
1 . A pump must be selected Eo delivcr a� 1.ensC 2�• 6 ,, gpm
with at least 2 O, g feet of total head�. �
D. To tnaximize pump liEc 5ul��cl' sump sizc fc�r 4 Lo 5 ptiui��
operations. per d:�y. � , .
I?. Calculate drainb:ic�k
1 . Determine Cotal pi.��c Lenf,L-h, �O fcet .
2. Determine liquid volume of. pipe,Y�,�� 'p,allons per " •
100 feet. (Sec page 1:-18) '"' - ' � ' .
3. Multiply length by volume: Drainbacic quantity =
e�� feet x 7.7 7 �allons/100 ft = . 2 �allons
4. Suggested drainback quantity is l0 percent of pumped quantity.
A larger drainback percentafie will decr�ase pump station
efficiency• sli�htly but pumpin� encrGy coSts are USLl811y a
relatively smzl] r�rt oE the tota7. h�usehold enerry costs. •
B-39
. PERCOLATION TEST DATA SHEET
Test hole location S�U rC./.0 S Hole number �
� Date test hole was prepared 7— 2�j/^' 9l , Deptn of hole bottom,�,� inches.
Diameter of hole, �_ inches.
Soil data from test hole: � "" � � � ..
Depth, inches Soil t,exture
(J -/S /�'�it �K' !O./r�
Method of scratching .sidewall ,S C �����
Depth of pea-sized gravel in bottom of hole, inches.
Date and hour of initial water filling 7-Z � � ��/ ,
��� _,
Depth of initial water filling, • �s inches above hole bottom.
Method used to maintain at least 12 inches of water depth in hole for at least
4 hours ��/ � � .. .... ... . .,.. . .
Percolation test readings made by ,j�� 1 r,P�N b L-� �- on
�—2,s 9/ starting at �,� a.m. . Maximum water depth above hole bottom
(date)
�
during test, � inches.
Time Percolarion
Time Interval, Measurement, Drop in water rate, Remarks
Minutes inches level, inches minutes per
inch
� � , L
/ .. - ► LC-.
w , , r 3 , , � ...
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� I . I � �r� S,7` � ��y GJ / ' '
U �
I I � � �- � �
// I � 1 3
Percolation rate = g �,� minutes per inch.
. - . B-39
PERCOLATION TEST DATA SHEET
Test hole location ,5 / U/)�S Hole number �
� Date test hole was prepared 7—Z[�. —� f , Deptn of hole bottom,� inches.
Diameter of hole, _� inches. �
Soil data from test hole:
Depth, inches Soil texture
� '� �C.lfli t°atd/� ' � . .
d - /s' d.P�ct.�. t o.t rh
Method of scratchin� .sidewall _ .S r �P�T�_�E�Q � � �
Depth of pea-sized gravel in bottom of hole, 2 inches. _
Date and hour of initial water filling _'7�-�t,/— !�f ��' ��'f��,
Depth of initial water filling, f,'" inches above hole bottom.
. ,M�thpd used to main.tain at least 12 inches of water depth in hole for at least
4 hours ��F�L L
Percolation test readings made by �DII/ �T/f'�1/j„1(��/Q�. on
7'-'2s / startin at � �= .
� g .m. Maximum water depth above hole bottom
(date) •
�
during test, 3 inches. �
Time Percolation '
Time Interval, Measurement, Drop in water rate, Remarks
Minutes inches level, inches minutes per
inch .
o-o u L L.L
.._. . . ._ . .._ t �
+ � i � r
_ _
, � r � „ .
► r �� � .� ,.
� � . I� � �, I I
� � �� w � 2 � , � �
r � �, ►� .
`. . .
Percolation rate = // ) /_ minutes per inch. -
� B-39
PERCOLATION TEST DATA SHEET
Test hole location s/ U1JUs Hole number �-- �
� Date test hole was prepared '7—2 L��9'/ , Deptn of hole bottom,�� inches.
Diameter of hole, �_ inches.
Soil data from test hole:
Depth, inches Soil texture' "
_ - rl- /D �«�'"K �,,z.��
,
/O -is t�<a � c.�rn
Method of scratchinr� .sidewall _SG�A/ C �
Depth of pea-sized gravel in bottom of hole, inches. �� � ' '
Date and hour of initial water filling 7—2 y— 9/ ---� � r° �/y
Depth of initial water filling, /_.�' inches above.-hole•bottom. I
Method used to maintain at least 12 inches of water depth in hole for at least
4 hours /4E�/�� L,
Percolation test readings made by �p� �j-�d/V�j�,p� " on •
� - 2,S' 9'/ starting at �-� a:m: . Maximum water depth above hole bottom
(date)
�
during test, 7 inches.
Time Percolation
Time Interval, Measurement, Drop in water rate, Remarks
Minutes inches level, inches minutes per
. inch
L L:
/'!� � - � � ►
_ � �
� � t� .. / e , _ .
�� . •� � ... .3 2 � �
�� � f .. 7 .
�i �� 7 " .._.:. . _ . _. �
Percolation rate = 3� 2� minutes per inch.
� ' 8-39
PERCOLATION TEST DATA SHEET ,
Test hole location ,������ Hole number L�
� Date test hole was prepared �_2 Ttf�— q/ , Deptn of hole bottom,�� inches.
Diameter of hole, �_ inches.
Soil data from test hole:
Depth, inches Soil�texture
l� -/2 /�L.r!'K f DA/h '
/L /S ,�rP�Gviv Larl/J'1 �
Method of scratchinq .sidewall �C/P/�/�� -/� ' " �
Depth of pea-sized gravel in bottom of hole, _ Z i,�ches. , ,
Date and hour of initial water f illing �—2 t�— C�1 w�. p��
Depth of initial water filling, f�s inches above hole bottom. '
Method used to maintain at least 12 inches of water depth in hole for at least
4 hours � L ���
Percolation test readings made by j �" on
7— 2 S�"p/ startin at �' a.m. . �
/ g Maximum water depth above hole bottom
(date) •m• ,
� during test, g inches. � ����� � �
`: .,
Time � Percolation
Time Interval, Measurement, Drop in water rate, Remarks -
Minutes inches level, inches minutes per , �
" inch
LL
[-' 't L
, � _ a �,
' � ,
�
i� � • gi ... I � �i
�► ► • / S / �
•♦ � � / .� � //
�1 / ! �J .., . . .
Percolation rate = �� _ S,S minutes per inch.
T .. .
� • Lo�,s of Soil Borinrs 13_i8
, T.ocation .or Pro ject _�U ���___ ___� ____._—
Borin�s made by ����Q� ���/V�F��t-_ na�e _'— 2 y�,1____
• Classification System: MSHO ; USDA-SCS �_; Unif.ied ; orher _
`..�AuQer used (check two) : Nand �, or Poc,er ; Fli�ht ••�� ��, �6r•��ucket•�; other _
. . —-r--- --- --- � ---- ---—
Depth, • Borinp, nii�:her ' �I __ nr.Pth, T3orinr numher _ 2 __ _ _
' ln Surface elevation 5. 8� • in Surf.ace elevation 9�____
feet ,. • feet -
�c1 - - — o — - -- --- ---
�ifCAt �O�M . . $��1�':K �Za,��at . .
1 — , 1 �' • . ,
Gie,�r �RN cc�r te.rr�
. � � —. � —.
. �f'.t�c�.� �tw r l�►.t r►,
� 3 — BrP o�cv.� �6�r G�i�s� 3 -�-- , .. .
• . . , . . . �
. 4 — , 4 — � , i
. �
;
i
S _ 5 --- �
. ... �
' � — G _ ' ,. _ � . .
• . 7 -- � 7 . — . ,.,,_ ,. ,
. 8 — $ — �
, I .
Fnd ,of boring at y !> f.eet. Lnd of borine at .�_ feet.
. Standing water table: StanciinF water table: . '
F4esent at feet of depth, Present at feet of.� deP�h,
, hours af.ter borin�. l�ours af.ter horinn.
tiot present in borin� hole �_. Not present 'in bor.in� hole � ,
{ . . . ,. .'.
' �Sottled soil : Mottled so�'1:••• ••• •••••• • � �
, Observed at �. 2 feet of depth. ' nbserved at Z Q feet of. depth'. '
' Tlot present in boring hole _ Not presenC in borinr hole
Obs�rvations and conunents: Observations.and commerits:
APPLICATION FOR SEPTIC SYSTE�yl PER'�IIT
CITY C�`i'`Oi�3N0
�-",og 66 (1335 So Brown Rd)
Lz�stal Ba�. �I 55323
*�***f**:*�********************f***��******#********�t***��**�**���****�**:�r
Ge:�eral Instructions :
1. You may apply for septic system permits by mail or in person at the
City offices. However, permits will not be mailed out and must be
picked np in person at the City offices.
2. Permits are not valid until you receive a permit card.
3. Work must not begin unless the permit card is available on the job
site.
4. Permits will be issued only to contractors holding a City of Orono
Septic System Installer' s License.
5. 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.
6. 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 instaY lation in the rock bed.
d) Final inspection to verify proper final cover depths and to
verify that all pump station (where required) components are
functional and complg with codes.
7. Individual ho lding MPCA Installer Certificate shall be present during
installation. 24-hour notice is required for all inspections.
*�*�*��r�****�**t:***�******s**�t**�*�r*:�::s**:**�*��t*3 *�*��***�*�t*�****��t�r
�- , / /
JOB SITB ADDRESS: / C�U ��L�yS C
Occupancy Type: Residential Commercial Other
Owner' s Name:ii'/r"S � �� s L�ti!S' Phone:
Mailing Address: City: Zip:
Septic Contractor' s Name: �/-�- �i► ss ✓ ,� G Bus. Phone:�7 - 3��
Mailing Address: �YS �1.�. :�c. ,�e �oG City: h�� � x� Zip:.S�s-�S
t�r:**�:*�:**�::�**��:*:*:***:� �***:�***:::*:�:**:** **:*:**:��**�t*:t::**�
- over -
SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2
... . ,..
Permit Type & Fees (check one)
� �N � Construction, Full System $75. 00 . . . . . . . . . . . . . . . . . . •
`"Replace Existing System (1 or more new tanks & drainfield) $50. 00 . . .
,_Partial Replacement (replace just tanks or just drainfie3d ? $30. 00. . .
$0. 50 State surcharge added to above Fermit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT MAIL PAYMENT WITH THIS APPLICATION
***��*******************************************�***************�****�*****
NOT$: Applicant must initial alI spaces. Fill in al 1 appropriate blanks,
c eck all approFriate boxes. �
I 1
1. I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
2. I wi 11 be insta l ling the fo 11 ng:
A. Tanks: �Precast Concrete Other Manutacturer
Tank Capacities: 1) ��gal. 2) ��/6� ga. 3 )_ �� gal.
{,� ��(.c_�� �-�
B. Pump Station (if re ui;e_� UJ�d�I ` �
Pump make & mode � � . a e &
literature) ; system design requires gpm at / ` feet
of head. High water alarm make & model � , s- ,c '� C' .
Outside electrical work to be completed by nstalle
electrician other Inside electrical work
must be completed by electrician:
C. Treatment System:
Trenches : s.f. 1 Mound
Depth of rock below pipe " Rock bed dimensions J'�'xy�'�
Drop Boxes Sand bed dimensions��'x '(�'
Distribution Box Pressure Dist. Pipe Diam.�"
Manifold Pipe Diam. ,��r, '
D. Final Cover/Topsoil to be: borrowed from site
�(show location on site glan)
trucked in
****#�****��:*#�*******:*:*:***********�:*#�***:**��***************�***t***
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 the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this app lication
are complete, true and correc .
.,
� � �
Signature of Applicant Date: ��
MPCA Certification No. : ��� ,
O� �p ��S'Su �
2�2�- q
D TE TIME
CITY OF ORONO CALLED IN '� � ,��,�
INSPECTION NO� SCHEDULED
PERMIT NO. COMPLETED ��� ��
ADDRESS � r
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION 1`�1
� 01 FOOTING 1 ECHANICA RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24/25'WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REM01/AL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP OB PRQGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 CQMPLAINT
i09 PLUMBING RI �1Fi��IC IN 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTI�Pf�AL
� OWNER/CONTRACTOR TO MEET YO :Y�YES_ �
y COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOYERING PERMANENT
�CORRECT UNSAFE CONDITION WRHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTIONREQUIRED.CALLTOARRANCaEACCESS.
Call for the next insp�ctbn 24 hours in advance.473-7357
ownedcontract
Inspector:
WMta Capyflnsp�cta's FlN Cenary Capy/Sib Notia (�
�t���" ATE TIME
CITY OF ORONO CALLED IN � 3 �'�
INSPECTION NOTIC SCHEDULED � ��5�
PERMIT NO. cOMPLETED
ADDRESS ��0 -�v b,b� �,/ �c�•
OWNER �'li� Sfc.b.ds CONTR.�. T�7i� -1cLtisoh�aC c' -
TELEPHONE NO. ��3 •`�� �
� DESCRIPTION . ���
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTAL� 22 FOLLOW-UP
J 10 PIUMBING FINAL 23 SEP IC FINAL
� OWNEHICONTRACTOR TO MEET YOU�YES_ O
� COMMENTS: � � ,���� �1�1�(.�"��C� -�C�
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W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. - PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r n 'te: -
Inspector. �'
White Copyllnspector's File Canary CopylSite Notice
.j
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO ICE SCHEDULED � �
PERMIT NO. COMPLETED
ADDRESS
OWNER � CONTR. �PI'�'L J�i114�--
TELEPHONE NO.
� DESCRIPTION ��1� �f
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING ti MECHANICALFINAL 18 EXCAV/GRADING/FILLINCa
y 03 INSULATION 24/25'WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC 21 COMPLAINT
= 09 PLUMBING RI 5 SE I INSTALL 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTI INAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
��„ COMMENTS:
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W
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V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RERIRN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTIONREQUIREO.CALLTOARRANGEACCESS.
Cali for the next inspection 24 hours in advance.473-7357
OwnerlContra r e•
Inspector.
White Copyflnspectar's Flk Canary CopylSPos Notlos �
✓
DATE TIME
CITY OF ORONO CALLED IN �G�=��� �
INSPECTION NO SCHEDULED �'1� '
PERMIT NO. COMPLETED �' �%
ADDRESS
OWNER CONTR.
TELEPHONE NO.
�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INST 22 FOLLOW-UP
J 10 PLUMBING FINAL EPT C F 1
2 OWNERICONTRACTOR TO MEET U: ES NO
y COMMENTS: " �
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W ❑CORRECT YYORK 8 PROCEED �ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
0 CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-7357
OwnerlContract s e:
Inspector.
White Capyllnspector's Fik Cseary CopyISIN Notfce