HomeMy WebLinkAbout2003-P07080 - repair septic PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07080
Crystal Bay, Minnesota 55323 Permit Type: Septic
(952) 249-4600 Date Issued: 12/16/2003
SITE ADDRESS: 3743 Watertown Rd
Maple Plain,MN 55359
PID: 32-118-23-34-0012
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Septic Permit Sub-type(s): Repair 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: S 50.50
APPLICANT: Dale Denn OWNER: Ned&Lorna Butterfield
1108 Goldenrod Lane 3743 Watertown Rd
Shakopee,MN 55379 Maple Plain MN 55359
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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APPLICANT PERMITEE SIGNATURE I SUED BY SIGNATURE
Covies: 1-File(Siznitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessine, 1-Finance Page 1
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City of Ororo
P.O. Bax 66
Crystal Bay, MN 55323
i 9,,2)249-46U{�
116f03
08:55:42
Customer- P07080
PERMITS - GENERAL
Base Fee
1 R 50.(K) 50.00
Plan Review.
1 @ 0.00 0.00
Mail in Fees
State Surcharge,C+ 0.50 Q-50
SAC Char
1 P 0.60 0.00
Investigation Fee
1 8 -0:00 0.00
SUBTOTAL 50.54
TAX 0.00 .
TOTAL SALE 50.50
Check Received 50.50
Dec-05-2003 03:29pm From-CITY OF ORONO +9522494616 T-505 P.001/002 F-224
CITY OF ORONO SEPTIC SV$TEM PERMIT APPLICATION
Box 66(2754 Kelley Parkway)
Crystal Bay,Mn 55323
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JOB SITE ADDRESS
Occupancy Type: Residential Commercial Other
Permit Type: New or Replacement System $100.00
epair xisting System S 50.08
anks or Drainfield)
iP,E Fig, f�d�fiE— 6 "✓�'.S
$0.50 tate surcharge added to above fees
/* See fee schedule for non-residential permit fees
Owner's Name: lwe— ,!J!/T�_ iE�/ Phone Number: _
Mailing Address: City: Zip
Contractor's Name: Phone Number:
Mailing Address: ,��tAA541WV 141City- Zip: . t1
*** DO NOT MAIL PAYMENT WITH TRIS APPLICATION***
".'NERAL INS'Y'RUCTIONS
1. Applications for septic system permits may be mailed or submitted in person at the City
Offices; however,permits will not be mailed out. The permit must be picked up in person
at the City Offices and work must not begin unless the permit card is on the job site.
2. Permits will be issued only to contractors holding a lV U- Mesota Pollution Control
Agency(WCA) Septic System Installers License.
3. All work must be done in accordance with the approved septic system design. Design reports
are not considered approved unless accompanied by the "City of Orono Septic System
Approval" cover sheet signed by the City Inspector.
4. The following inspections will be required for all septic systems-
A- Pre-installation site inspection to include inspector, installer,and general contractor.
B. Tank installation prior to covering.
C. Drain$eld 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), andagain
during pressure distribution piping installation in the rock bed.
D. Final inspection to verify proper final cover depths and to verify that all pump stations
(where required)components are functional and comply with codes.
5. Individual holding MPCAYnstallers License shall be present during all inspections. A 24-hour
notice is required for all inspections.
Dec-05-2003 03:30pm From-CITY OF ORONO +9522494616 T-505 P.002/002 F-224
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate
boxes. (13 Jk /&
1. I have received a copy of the system design including the City of Orono Septic
System Approval Cover Sheet. �^ (73To�6
2. I will be installing the following: /G'� f,Coi� �l� � /c
A. Tanks: Precast Concrete Other Manufacturerr
Tank Capacities: 1)_ gal. 2) gal 3) nal
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.
C. Treatment System:
Trenches: s.f. Mound
Depth of rock below pipe" Rock bed dimensions ' x '
Drop Boxes Sand bed dimensions 'x '
Distribution Box Pressure Dist, Pipe Diam. "
Manifold Pipe Diarn.
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan)
trucked in
The undersigned hereby applies to the City ofQrono for issuance ofa septic system installationpermit,
agrees to do all work in strict a. ance with ordinances of the City and the regulations of the State
of Minnesota,and certifies ttcc 1 statements m eon this application are complete,true and correct.
Signature ofApplicant G/haDate ®3
01
MPCA License
Staff Review: Approval penial
Reviewer: y r i �qzl( _ Date:
Reason for Denial:
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N C SCHEDULED
PERMIT NO. COMPLETED d
ADDRESS S � � wn R
OWNER 3743 CONTR. 1',8- 5j)--f-
TELEPHONE
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TELEPHONE NO.
DESCRIPTION }'
4 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/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-SITE2 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL UPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
OWNERICONTRACTOR TO MEET YOU:RYES_NO
COMMENTS:
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LU ;'WORK SATISFACTORY-PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
OO ❑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
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 ours in advance. (952) 249-4600
Owner/Con Rc^tor-on site: A
S S b
Inspector.
White CopyMsimtor's File Canary CopylSlte Notice