HomeMy WebLinkAbout1997 - 009414 - septic system A PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number:
Crystal Bay, Minnesota 55323 0091 4
(612) 473-7357 Date Issued:
SITE ADDRESS:
sr; WEAR LA N
DESCRIPTION:
SEPTIC SYSTEM
Sewer & Water Permit Type NEW SEPTIC :\/: TC
Mer Work lypk7: RE!7;IDENcE
REMARKS:
FEE SUMMARY:
.Jase Fee $100 . 00
Surcnarg -4-jac2
iota' Fet: $100 . E,0
CONTRACTOR: '-- Applicant -
WESTONKA SEWER & WATER INC S472,1966
COUNTY RO 1S WEAR LA N
MN K-, 64 ORONO b!nbt7.=
( 1.2)
THE UNDERSIGNED HEREEN . :EQU :STS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED ANO AGRFES Tj Do Ail_ WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO oRDTWNCESAN- ' ATE OF MINNESOTA PUTLOTNG CODP RFOUTREMENTS .
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO SEPTIC SYSTEM PERMIT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay, Iv N 55323
JOB SUE ADDRESS: r 2c2, e
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
Owner's Name: 7:_e) O Phone Number:
Mailing Address: City: Zip:
Contractor's Name: �`: M . '� �*/ Phone Number. ?-7-L/�66
Address: n� City: 04o 4 he Zip: -5'S-'3,/7
Mailing �j�j( Gv 1
DO NOT MAIL 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.
TS- 1. I have received a copy of the system design including the City of Orono
Septic System Approval Cover Sheet.
j -, 2. I will be inst • g the following:
A. Tanks: Precast Concrete _ Other Manufacturer .'',.-.)1.1 ss
Tank Capacities: 1) J c OZ) al. 2) ke,0 gal. 3) 16_ ,,c) gal.
B. Pump Station (if required)
r �
Pump make & model (2 f� (attach. .u1np curve &
literature); system design-tequues t gpm at `_;;r!. ' eet,of head.
High water alarm make & model .i4v<< ,r .-, f�'ti,kicoutside
electrical work to be completed by installer electrician
other . Inside electrical work must be completed by
electrician.
C. Treatment System:
r
Trenches: s.f. Mound 'j�
Depth of rock below pipe " Rock bed dimensions J0'x 7 6�
Drop Boxes Sand bed dimensions�$a5, 'x_ 4- c
Distribution Box Pressure Dist. Pipe Diam. I i/V, "
;Maniford Pipe Diam. oZ "
4:,„;
D. Final Cover/Topsoil to be: '''borrowed from site
by (show location on site plan)
/b 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 •.t all statements made on this application
are complete, true and correct. ,, -)
9i
SignatureofApplicant: 1. ),__ d` Date: y I�� -7
MPGA Certification No.: -c-i• V -p--...__ g—`?0— '= 7 if2-e0‘%Sec6
Staff Review: Approv. �\ Denial
/
Reviewer: /0,i i it , Date: 7: /1-"/ ��
/ #�-9 7
Reason for Denial:
DATE TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTICESCHEDULED /0 ' tine-
PERMIT
NO. �ct/ COMPLETED
ADDRESS L 4
OWNER ( < CONTR. I •
TELEPHONE NO.
DESCRIPTION i • - • i t
4. 01 FOOTING 11 MECHANICAL RI / 18 EXCAV/GRADING/FILLING
h 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
i` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL • 15 SEPTIC INSTALL.' • 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
OWNER/CONTRACTOR TOEYOy:_YES NO
C3 COMMENTS: /4a/c
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OORK SATISFACTORY:PROCEED PROJECT COMPLETE
CC ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor o
Inspector. /ira/�G 6
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED / —`T7 42W
PERMIT NO. /.//4/ COMPLETED
ADDRESS . 5 /.6 �CUY1 Al)/ ,✓ '
OWNER CONTR. u 1.510') a
TELEPHONE NO.
DESCRIPTION
4. 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
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02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREIWETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
I` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
tQ 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
OOWNER/CONTRACTOR yl Yct �U: YES, / IQt_ /
v, COMMENTS: C
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
U INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor i1 '. • /
Inspector. ' .
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN l'- /f'- `l 7
INSPECTION NOTICEoy 1 SCHEDULED 9 -i S-' v2 ;at'
PERMIT NO. / 7 T COMPLETED "`
ADDRESS - S kIt_4/t_ At Al
OWNER e0-61--z—r) 6-11-4-t- CONTR. 11,42,4, ,o-stA 64--
TELEPHONE NO. V7 -1.41 9 C'O
DESCRIPTION / C2;Y 4--
L 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
I` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W C 07 DEMO—FINAL 15...SEPTIC INST II j 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Q OWNER/CONTRACTOR TO E YOU: Y S NO 1
• COMMENTS: — #J2 &f)' - 0 P��Ld I i L.
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W L CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
IT
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
El INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerContractorn ' e: .
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nspector. div, I /
/
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITF
IN
Y NO CALLEDEDL
INSPECTION NO CE SCHEDULED1272 *-172-E
PERMIT NO. L'`F / COMPLET D
ADDRESS 5 /i%'YI
OWNER CONTR. fikl
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TELEPHONE NO.
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
h 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
i` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
delb= 09 PLUMBING RI 35 HARD COVER REMOVAL
�+ 10 PLUMBING FINAL • • • - ' NGLES 36 FOUND•TION REMOVAL
Q OWNER/CONTRACTOR TO . YOU: YES •
AP
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W ❑CORRECT WORK&PROCEED 71 ISSUE CERTIFICATE OF OCCUPANCY
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 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in a•vance.473-7357
Owner/Contractor,
Inspector. e7� L i /116PIF//ff
White Copy/Inspector's File Canary Copy/Site Notice