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HomeMy WebLinkAboutApproval application for permit for connection to use facilities EXHIBIT A Supplemental Data Sheet PERMIT NO. Community Date ,� Individual Making Application Phoned Representing Who Who , Location of Connection D . Work to be Done by. Type of Connections�IId.�L Depth_ - Size of Connecting Sewer i,7 ��_ Py(-1 Pipe Materia xW-' Invert Elevation Area Served in Acres: Residential Commercial !� Industrial Predicted• F ow in Gallons Per day ht�� Initial © Design Characteristics of Discharge: Residential Commercial_ Industrial Unusual Characteristics of Above (Strength, Oils, Chemicals, Temperature & etc. ) Page 3 of 3 n.c wo. . ST Heavily Galvanized Body Designed for Maximum Strength and Rigidity IfNeoprene Gasket Cemented in Place Flattened for Greater Stability and Resistance to Corrosion Strap Heavily Cadmium Plated Curvature Accurately Designed to Ft Pipe • 1 ti_ Threads Precision Machined to Close Tolerances `_: Thick Boss with Full Length Three Threads Cadmium Plated Rolled Steel Nut,Cadmium Pla Tough Malleable Iron Body =•., Extra Large Forged Steel Strap SINGLE STRAP. DOUBLE STRAP Available with GASKET SUPPORT ;rjC (�ti INSERT Service Outlet KEMWTEO IN RACE) --y 4 i PIPE STAINLESS STEEL GASKET BAND TYPICAL SADDLES FOR CONN-ECTION Ilm SURIECT" SM& PRESSURE SEWER CONNECTION TO MWCC INTERCEPTOR FORCEMAIN NONE Ka 3-9-94 MWCC METROPOLITAN WASTE CONTROL No. �Elf. ENGINEERING/CONSTRUCTION COMMISSION A DEPARTMENT STANDARD INTERCEPTOR DETAILS SNDA PL. ST. PAUL MINNESOTA PERMIT It has been determined that Applicant has adopted a comprehensive sewer plan, has submitted it to the MWCC as required by law, and that the proposed connection to, or use of, MWCC facilities conforms to the adopted comprehensive plan or adopted comprehensive plan or adopted revisions thereof. Permission is hereby granted to Applicant for connection to, or use of, MWCC facilities in accordance with the description provided by Applicant. This permit is issued under the following terms and conditions:- 1. The provisions of the Waste Discharge Rules for the Metropolitan Disposal .System, Minn. Rules, Chapter 5900 apply to activity carried out under this permit. 2 . This permit does not replace permits required by the Minnesota Pollution Control Agency or the necessity of securing other permits and fulfilling requirements of other governmental units . 3 . The MWCC's issuance of this permit does not constitute a certification that the project design and construction proposed by Applicant meet engineering standards. Applicant remains responsible for design and construction, including safety, for the project. Applicant's attention is specifically directed to the confined space rules adopted by the Minnesota Department of Labor and Industry, OSHA Regulations, Parts 5202 . 100 through 5205. 1040 and 5207. 0300. 4. . This permit shall be' null and void if the connection proposed by Application is not made within 90 days from the date of issuance. 5. This permit is subject to modification or revocation and may be suspended at any time for .failure to comply with its terms. Issuance Date ''Z —W METROPOLITAN WAS CONTROL COMMISSION By Assistant Di ect , E ering/Construction Department Page 2 of 3 Metropolitan Waste Control Commission Mears Park Centre,230 East Fifth Street, St. Paul, Minnesota 55101-1633 612 222-8423 PERMIT NO. INTERCEPTOR 3- APPLICATION AND PERMIT FOR CONNECTION TO, OR USE OF, METROPOLITAN WASTE CONTROL COMMISSION FACILITIES (Note: this form must be submitted in duplicate) APPLICATION The City of hereby applies for a permit for connection to, or use of, Metropolitan Waste Control Commission .(MWCC) facilities. A. description of the proposed connection or use is attached to this Application as Exhibit A, Supplemental Data Sheet. By execution of this Application, the Applicant agrees to: 1. Provide such additional information as is requested by the MWCC. in order to make a determination on permit issuance. 2. Abide by the permit terms and conditions set forth below and all applicable state and local laws, ordinances, rules and regulations. 3 . Pay all applicable permit fees (i.e. , service -Availability Charge and . Industrial Strength Charge) in accordance with MWCC rules and regulations. 4.. . Reimburse the MWCC for any damages resulting to the . MWCC's facilities as a result of the connection or use of its facilities. 5. Indemnify and hold harmless the MWCC, its employees, agents, and contractors from and against all claims, damages, losses and expenses, including but not limited to attorney's fees, arising out of or, resulting from the connection. to, or use of, MWCC. facilities, provided that any such claim, damage, loss. or expense ' (1) is attributable to bodily injury, sickness, disease, or death or to injury to or, destruction of tangible property, including the loss of use resulting therefrom, and (2) is caused in whole or in part. by any negligent act or omission of the Applicant, its contractors, subcontractors, or anyone directly or indirectly employed by any of them, regardless of whether or not it is caused in part by the MWCC. Dated �O 2 Z / CITY OF SIGNATURE r✓� arm Print Name/: �oAJ1-1 Title: o Page 1 of 3 ZD/92 Equal Opportunity/Affirmative Action Employer Metropolitan Waste Control Commission Mears Park Centre, 230 East Fifth Street, St. Paul, Minnesota 55101-1633 June 28, 1994 612 222-8423 REC! "°t. J U N 3 0 1994 Mr. John R. Gerhardson Public Works Director CIN OF ORONO City of Orono P O Box 66, Crystal Bay Orono, MN 55323-0066 RE: Permit for Connection To or Use of MWCC Facilities Permit Number 1268 Dear Mr. Gerhardson: This letter is to inform you that the Metropolitan Waste Control Commission (MWCC) has approved your application for Permit for Connection To or Use of Commission Facilities. Enclosed is your approved MWCC Permit Number 1268 for the connection of an 2" PVC sanitary sewer to the MWCC's Sanitary Sewer Interceptor 83-52 located at 3505 W, . Wayzata Blvd. , in the City of Orono (see enclosed plan sheet) . Also enclosed is an extra copy of the ap- proved permit. This copy should be provided to the contractor who will be making the connection so that s/he is aware of the MWCC's requirements. Please note that the connection shall be made in accordance with Standard Details, which are attached to and made a part of Connection Permit No. 1268. It is required that the City contact Mr. Wally Wessels' office at telephone number 612-772-2585 (7 : 30 a.m. to 4 : 00 p.m. ) and make arrangements to have an inspector on site at the time the connection is being made. A minimum 48-hour notice should be given. Please refer to the permit index number when requesting an inspection. PLEASE NOTE: If the Commission's inspector is not notified prior to installation of the connection, the applicant will be required to pay all costs associated with re-excavation and inspection. Sincerely, --tCarol L. Jo on ."Real Estate cialist CLJ:bw cc: W.R. Wessels, w/enclosures E.J. Bloom, w/enclosure Equal Opportunity/Affirmative Action Employer