HomeMy WebLinkAbout1997-008932 - repair septic PERMIT
CITY OF ORONO
PERMIT TYPE: ��, r, WP�T FR
2750 Kelley Parkway- P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323
(612) 473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
CONTRACTOR: OWNER:
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APPLICANT/P ITEEIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO SEPTIC SYSTEM PERMIT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay, NUN 55323
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JOB SITE ADDRESS:
Occupancy Type: Residential Commercial Other
Permit Type: New or Replacement System, $100.00
Repair Existing System, $ 50.00
(Tanks or Drainfield)
0.50 State surcharge added to above fees
*See fee schedule for non-residential permit fees
PhoneNumber:
Owner's Name: L.,, Lr���
Mailing Addres _ I oneNumber: �' Zip:
Contractors Dame:
Mailing Address: g�L -e S' tr_ City: Zip: is�..
DO NOT 1VIAIL PAYMENT 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. Permits will be issued only to contractors holding a City of Orono 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 station
(where required) components are functional and comply with codes.
5. Individual holding MPCA Installer Certificate shall be present during inspections. A 24-
hour notice is required for all inspections.
-
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, 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 installing the following:
A. Tanks: _ Precast Concrete _ Other Manufacturer
Tank Capacities: 1) gal. 2) gal. 3) gal.
B. Pump Station (if required)
Pump make & model (attach pump curve &
literature); system design requires gpm at feet of head.
High water alarm make & model Outside
electrical work to be completed by installer electrician
other Inside electrical work must be completed by
electrician.
C. Treatment System:
X4 Trenches: s.f. Mound
Depth of rock below pipe " Rock bed dimensions 'x '
a d� a a"W-A- Drop Boxes Sand bed dimensions 'x '
Distribution Box Pressure Dist. Pipe Diam. "
/6 64 Maniford Pipe Diam. "
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 the ordinances of the City and the
regulations of the State of Minnesota, and certifies that all statements made on this application
are complete, true and correct.
SignatureofApplicant: Date:
MPCA Certification N .- 9
Staff Review: Approval Denial
Reviewer: Date:
Reason for Denial:
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE �� SCHEDULED `
PERMIT NO. COMPLETED
ADDRESS
OWNER CONTR. Ca
TELEPHONE NO.
DESCRIPTION
01 FOOTING 11 MECHANICAL I 18 EXCAWGRADING/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 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 S MAINT. 21 COMPLAINT
v 07 DEMO-FINAL PTIC INSTA 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YO --YES—NO
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COMMENTS:--
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WCC WORK SATISFACTORY.PROCEED ROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR F_ CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73557
Owner/Contractor
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY NO CALLEDIN
INSPECTION NOTICE SCHEDULED
PERMIT NO. c MPLETED
ADDRESS yI
OWNER CONTR._ZT R*J=C�
TELEPHONE NO.
DESCRIPTION
W 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
LIL 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTI STALL. 22 FOLLOW-UP
09 PLUMBING RI EPTIC FINA 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO '>
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COMMENTS: '— h-
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LAJ ❑WORK SATISFACTORY:PROCEEDROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR F CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice