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HomeMy WebLinkAbout2010-00612 - new septic P CITY OF ORONO PERMIT NO.: 2010-00612 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 08/06/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 920 WAYZATA BLVD W PIN : 35-118-23-41-0006 LEGAL DESC : UNPLATTED 35 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEPTIC PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : NEW ACTIVITY : MOUND SYSTEM-SEPTIC NOTE: (3)PRECAST CONCRETE, 1000 GALLON TANKS MOUND SYSTEM-380 S.F. WELL MUST BE ABANDONED OR VARIANCE OBTAINED FROM M.D.H. APPLICANT SEPTIC NEW 200.00 HAYES&SONS EXC.INC. STATE SURCHARGE SEPTIC 5.00 263 82ND STREET S.E. TOTAL 205.00 MONTROSE,MN 55303- (763)479-1762 PAID WITH CC# 5293 Minnesota State License#: 640 OWNER CHIODIAN,HEATHER&MICHEAL 920 WAYZATA BLVD W WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be re ..-d. any tim- for due cause. / �► / .// / fD / l / tet_ j,/ 3)3/1° e /U pplic. ;<!' itee Signature DateIssued By Signature SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono FOR CITY USE ONLY 4-4/1.0:4po \\ POBox662750 Kelley Parkway Date Received: 7P-2-110 Permit# .fr/O "(I, 6'/L Crystal Bay MN 55323 i 0, 4 (952)249-4600 Amount: $ U1a5.619 CITY OF ORONO - SEPTIC SYSTEM PERMIT APPLICATION (All permits must be approved by the On-Site Septic Manager and/or Building Official) Site Address: 9 zoo W ze-L` . I VC Owner: 01 }Ce l .Vil'C9GG Mailing Address: 920 td-47-,k.4c ( ( J, City: 0 VCy Q Zip: Home Phone: r(Z- V76 --d 731 Alternate Phone: 4/Z - 64;i - 73 60 a 0 it/Applicant Information: Contractor/App.: I p‹.7 4--Swr � �S Contact Person: P Address: 24 3 2`— $4- . S State License #: YcCr LK City: f/hJ'l-`ifruS-e Zip: S- ----3(o 3 Expiration Date: ?6/ Z-- Phone: -2e.e. ?-- (4--7 S - (96 r2— Alternate Phone: ('p (2_ - 6 3-5-_` oi5Z) � x * ,`�F# „,-,,„, °wet"'xv 'v»�r ,c x ., �§,.�, 3 T iw3 . .. ,� ,..s. ., 9s....v .,..,._ ,.,.,.ate , ,esidential ❑ Commercial ❑ Other ''',7,::,7,-,:::::,.„,-,::,„ ` t :. ." ,:g.:`t, ,., '� w °d' fes' '"�"i �'" s= : ,, i® ` €. �$ s1,* ^w+'�,4'T,,: ',� 17'x:" e' »._,.�:� G_;.�., �- '.,asx �€ ,;.. �o. au� ss�s6.��aa��.�r.�.,��"..�.�.,�.�.a ,a�s�5; .� :.;m6��:. New or Replacement System $200.00 ©0 Repair Existing System 100.00 (Tanks or Drainfield) State Surcharge 5.00 5.00 Total $ 2_c, --c, g .=- W:\(Permits)\Septic Permit Application-Updated Surcharge 7-1-10.doc 1 / 2 S ' { u prtL 4 ;„ wW I will be installing the following: T s Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other (list manufacturer) Number of Tanks: 3 Size of Tanks: (COO 7000 Treatment System Trenches s.f. Mound s.f. Gravel less s.f. Chamber s.f. NOTE: The contractor is required to provide an As-Built of the system before the final inspection. The undersigned hereby applies to the City of Orono for issuance of a septic 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 ___t47Date: 1 _ z ( 0 MPCA License No.: (p Yo Staff Review: ccept ❑ Denied Reviewer: /L 001P' Date: 7-,2-F-10 Reason for Denial: Comments (to be printed on inspection card): L-A--) 1 13e- 0 A ,tcioAeci or UAB:ice 0b-r:A, *fed ' Cfoioi 1--L W:\(Permits)\Septic Permit Application-Updated Surcharge 7-1-10.doc 2 / 2 DATE / TIME v CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED 1 PERMIT NO. a D/O-066/ 2— COMPLETED ADDRESS y,7r ) ( A-(7,4 T4 '73U L� OWNER C 8, TELEPHONE NO. CONTRACTOR -{e3 J S. DESCRIPTION -�c LU ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING — Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti ❑ FRAMING ❑ MECHANICAL FINAL El TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO oco COMMENTS: cc W CC 3 — ccs (3-- Si mowAY.1 CC cc �cSo r 1� n _ f� fwd z a Lu El WORK SATISFACTORY:PROCEED LAB VROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ E CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN CISTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED El INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: (-4Inspector. White Copy/Inspector's File Canary Copy/Site Notice • -i- D T TIME V CITY OF ORONO CALLED IN )7//0 ii` 46 D INSPECTION NOTICE SCHEDULED / / -�.d_.• PERMIT NO- AP 0'00 /A COMPLETED t�_ ADDRESS JFdD 4110/ C//l,� OWNER / ' a PHONE NO. $5-/q/550 CONTRACTOR `v >: DESCRIPTION , `� I-. IQ ❑ FOOTING ❑ PLUMBING FI AL 0 EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB ❑ WATER HOOK-UP LI PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP st Z ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI CISEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: 43 CO : I + 1JQ(ci ed ccW Q. CC O �/1ofin c . L.4s 4-, As C2S, 74ecl N. ( .4. i ( i?/vat old well Q. A 3c)n. cinn1P ci -- .'J PP Pi y Lx.-( ( 106- Q., cc 3 - Imp Cr i c oi\.) A^ccs Y'p7ci c. -1- F,, 1+cs Q~ $ - 4K �/a 2 6-rx)i t,S P u4,,.,? j PtiJM nJC L�AAg8c! 4A3 l�O.j ' Z7 `P O Lu ORK SATISFACTORY:PROCEED ❑ PROJECT COM Erfd W 0 COf2RECT WORK&PROCEED El CERTIFICATE OF P Y O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. 6-i r3 iT White Copyllnspector's File Canary Copy/Site Notice