HomeMy WebLinkAbout1992 - 004117 - sewer/water replace PERMIT
PERMIT TYPE:
CITY OF ORONO
th .,4 Permit Number: !...—.)411 ,
1335 Brown Rd. South • P.O. Box 66 ,::::::::::Eur;"
Date Issued:
Crystal Bay, Minnesota 55323
(612) 473-7357
SITE ADDRESS:
2760 WHITE OAK C:IR
P1 . . : kj4 1 1- ,
DESCRIPTION:
Sewer & Water Permit TYPe
''.. .
cWater Work Type REPLACE.-.E ;i-:
FING
REMARKS:
FEE SUMMARY:
BEte Fee
-rotal Fee
OWNER:
. ,1+ -
KA1HERINE
CONTRACTOR: - A plic .,
!::.,4 7 1 - 1 ....''1 '..:-..HPINNCIN
-.--... - cTR
WHITE Oi-fr--. ... ..
MN bE.:-.7:b6
PETERSON ELMER JCO
p,0 X 2:26 . _ . ...
Ci i--,:i...i r4 0
R R 2
- MN E.!-..-, 2(..-":
DELANO
( : 1-2) 471-2151
, -
.;;‘,
ALL CITY 0F,
,0', '*: `,' ' "'f --WIT -----' ,,,,,,e,.#
' iLt.:".0k44- ,,4 1:..2' ,p444,zo:.',IN'
o ,,,,,.:64t111,1qA4 , ,' ':'Y'-:--,f; 7, -zei0,1.-:-,:
'''', '",7''''""tmtvitatIt:441: - - .. . - ' '',. ‘,„ ' ,, - ' -. - '',-.7:-.i-?-111t-4,i,..;-4.'17-1,r,,I,,i--4:,-,'1..,.v.,,,,,,,,,,-'t,-,4
,! r.41k ' ';°...*:--., 1::...,,,- -..,- '
LL,—,‘,,,'s, :, , ,-
ISSUED BY SIGNATURP41-4)
APPLICANT/PERM ITEE SIGNATURE
Z4 1.7
APPLICATION FOR SEPTIC SYSTEM PERMIT
CITY OF ORONO 0 ‘` .ti,
Box 66 (1335 So Brown Rd)
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 willMbe 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: .27(0 Z7A/A TP r�'. ,L `_ v
Occupancy Type: Residential Commercial Other
Owner' s Name: k,_,A*1/17r,
��^✓gpi'y-i}--�
Phone:—
Mailing
hone:Mailing Address: `~;a77"'r°'� City: Zip:
Septic Contractor' s Name: Fic-11-1,5-c-,y, C . Bus. Phone:y'7/-8; 51
Mailing Address: g-6
2- L3 x ‘2,9, q City: ; ? c,(r r =- Zip: SS 3 2S
***************************************************************************
over - 43)1 rdi
t �G
SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2
Permit Type & Aeesit(check one)
New Construction, Full System $75. 00
Replace Existing System (1 or more new tanks & drainfield) $50. 00 . . . -
partial 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
k0 1. I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
ofle 2. I will be installing the following:
G A. Tanks: Precast Concrete Other Manufacturer
Tank Capacities: 1) gal. 2 ) gal. 3 ) ____gal.
( B. Pump Station (if required) (attach pump curve &
`14-c Pump make & model
literature) ; system design requires gpm at feet
/ A' of head. High water alarm make & model -
�(')3(� Outside electrical work to be completed by installer
electrician other
inside elec. .
.. icz.1 v.or}
_
must be completed by electrician.
-I'
C. Treatment System: Mound
Trenches: s.f.
Depth of rock-below pipe " Rock bed dimensions __'x '
Drop Boxes Sand bed dimensions _'x ' "
Distribution Box Pressure Dist. Pipe Diam.
Manifold Pipe Diam.
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan
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.
Signature of Applicant:
,� , z ,� •-''- ";14'-r---- Date: mc)'`. 3 / 771
MPCA Certification No. : 0(3
0-51-T DATEE TIME
CITY OF ORONO CALLED IN ` oo
INSPECTION NOTICE SCHEDULED 100
PERMIT NO. 417? COMPLETED '` 2;DO
ADDRESS ?7O I jQ- o k C
OWNER evthe nAgr�. CONTR. £J 14-i-efspiN
TELEPHONE NO.
DESCRIPTION
14.1 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
• 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 SEPT INSTAL 22 FOLLOW-UP
10 PLUMBING FINAL 23 SEPTI NAL
Z OWNER/CONTRACTOR TO MEET YOU:JEYES_NO
�/
COMMENTS:— S X/Cb Gift- 6:4;$17r- a 5i h
ckf ord Com amt,dcc
�&
preYe 101ry,
CC
CC
Lu
• 0 WORK SATISFACTORY:PROCEED EROJECT COMPLETE
CC
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor ' e•
Inspector. ►
White Copylinspector's File Canary Copy/Site Notice