HomeMy WebLinkAbout1991-004038 - partial replacement PERMIT
CITY OF ORONO ► PERMIT TYPE:
1335 Brown Rd. South - P.O. Box 66 Permit Number: SEWER WATER;
Crystal Bay, Minnesota 55323 Date Issued: 10/26/91
(612) 473-7357
SITE ADDRESS:
315 TONKAWA RD
LSV
P. I . N. : 06-117-23-14-0021
DESCRIPTION:
P ACEMENT '
Sewer u Water ' s e DRAINFLD, OR TANS;
Sewer "WaL
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CITY OF ORDNO
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FINANCE OFFICE
13133>�?rv440
01 GEN 30-00
REMARKS: IV
01 GEN . 4
FEE SUMMARY:
Base Fee $30 .00
Surcharge --.----_. .._I-5Q
Total Fee $•.0• SO
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CONTRACTOR: -- Applicant -- OWNER:
C:OPP I N PLBG : 47221.1 E. BENNETT FRANC:
',:�00 CHATEAU LA f 5 TONKAWA RD
MO;,ND MN 55:_,r.4 ORONO MN SS_.S€..
(612) 472-2:316
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
APPLICATION FOR SEPTIC SYSTEM �PERMIT
CITY OF ORONO •4
Bog 66 (1335 So Brown Rd) Y
Crystal Bay, MN 55323
General '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 up 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 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 Installer Certificate shall be present during
installation. 24-hour notice is required for all inspections.
JOB SITE ADDRESS: 'bV s `V-0 n"`a t-J o\
Occupancy Type: Residential L� Commercial Other
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Owner' s Name: Phone:
Mailing Address: (� City: 1 Zip:
Septic Contractor' s Name: Cly Q Q� Q u Q`� (Y Bus. Phone:
Mailing Address: 2,3Uo City: 0(_A-Q_ Zip: 5s3cA
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SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2A P.
Permit Type & Fees (check one)
_New Construction, Full System $75.00. . . . . . . . . . . . . . . . . .
ePartial
place Existing System (1 or more new tanks & drainfield) $50.00. .Replacement (replace just tanks or just drainfield) $30.00. .
$0.50 State surcharge added to above permit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT MAIL PAYMENT WITH THIS APPLICATION
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks,
check all appropriate boxes.
Initial
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)
(attach pump curve
Pump make & model &
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: Mound
Trenches:_ s.f.
Depth of rock below pipe Rock bed dimensions
Drop Boxes Sand bed dimensions L4 x-' "
Distribution Box Pressure Dist. Pipe Diam.
Manifold Pipe Diam. "
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plar
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. C
Signature of Applicant:
Date: d
MPCA Certification No. : ���
DATE TIME
CITY OF ORONO CALLED IN J!2- 4?
INSPECTION NO IC SCHEDULED /�-�t-91
PERMIT NO. COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO. i.�
DESCRIPTION -pack
01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
C 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
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 MANT 21 COMPLAINT
09 PLUMBING RI SEPTI 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTI NAL
2 OWNER/CONTRACTOR TO MEET YOU: YES_NO
COMMENTS:
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UjRK SATISFACTORY.PROCEED ❑ PROJECT COMPLETE
❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
+❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INISPECTKN!REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
(dimer/Contractor s' .
White Copy/lnspectops File Canary Copy/Site Notice
J DATE q, TIME
CITY OF ORONO CALLED IN fd`32`/I
INSPECTION NOT I SCHEDULED _
PERMIT NO. COMPLETED
ADDRESS �,�
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION—A—rd kx4k4,11�,
01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
h 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SE 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTI
2 OWNERICONTRACTOR TO ME YOU:_YES_NO
COMMENTS: "'
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uj WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
cc
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-7357
Owner/Contra or
Inspector.
White CopyMspector's File Canary Copy/Site Notice
CDATETIME
CITY OF ORONO CALLED IN ' 7 /'
INSPECTION NOTICE SCHEDULED l -
PERMIT NO. COMPLETED f
ADDRESS
OWNER CONTR.
TELEPHONE NO. _ 2'70P
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 16 WELL TEST PAP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADtNG/FILLING
y 03 INSULATION 24/25'WOODBURNER/FIREPLACE 19-L.AKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 T
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGR
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPT,PFINAL
OWNERICONTRACTOR TO MEET YONC YES_NO
COMMENTS: A �I
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W WORK SATISFACTORY PROCEED ❑PROJECT COMPLETE
cr. ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
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D ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C�.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN 11 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnetdContract IS e:
Inspector•.
Whha CopyAnspactoea File Canary Copyffi to Node*
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED A, 1N50
PERMIT NO. 562= COMPLETED 77—
ADDRESS Taeh/�
OWNER CONTR. 4U4b _
TELEPHONE NO.
DESCRIPTION 1 ' /
01 FOOTING 11 MECHANICAL RI 18 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
Co03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP 08 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SEPTIQ
J N.QALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTICF NAL
2 OWNERICONTRACTOR TO MEET YOU: ES_y COMMENTS Na
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41 ❑WORK SATISFACTORY:PROCEED EROJECT COMPLETE r"�
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY "
C1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContractor gin oft.
Inspector.
White Copylinspectoes File Canary CopylSite Notice