Loading...
HomeMy WebLinkAbout1994-006286 - septic system 4* PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway • P.O. Box 815 Permit Number: ` ` WATER Orono, Minnesota 55356-0815 Date Issued: (612) 473-7357 SITE ADDRESS: 4 4 Q !Tf I LLQ W- 1,P° - r-H DESCRIPTION: '3EP7'I C Sy!-E-TE-11 SYSTE '=:ewf.-y: Water Work. Type PE'=.II)ENCE REMARKS: i`TT* iii= i:i r ni r L1 I 1 LI 41fI Vr TV ! 1I1ff71fL•L L'1 ! lt•L FEE SUMMARY: j j;'.t J1?i� n ((V 31 VLl r VY r VV }•,•,•�'•1.�UVtVV YP 2 L i.tt L�2 LL� •,.'V Base "_ {_}f I, 00r'i;;•f.. Tii;i,I r.'A Surcharge _ _ 1 �t) L•rate� !L sLw.,iv Tc-tal I"'e - -- yl fi0 .1 0� 4 /1LfLLlf L!VllAtfl/tlV` IT.V • rrlivv VIl J1 A0 AR/6111/1-14, R/i l i 1-rl CONTRACTOR: — Applicant. — OWNER: =:i tLL `:tiia = '_; ;v I f`•E° I I�If x;47: 4:W:i�i 7 'F RR't' R 10-*.' 366o HWY 101 = 44�� W I LLi�i� OR ARCINO MN (F,1' ) 47:x;-431* ){7 IIn IrIDItSolEg R � S`I� P`� iT �Slc�.r .II E THE ,"II Y � IEI�1 . �C > €D ` `�' .AOS �. I Tl G ' GtPL §iE.� I TY �. CIRC IC E DT�WC S � � DIN6:CODE E APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE TQC CITY OF ORONO SEPTIC SYSTEM PERMIT APPLICATION Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 JOB SITE ADDRESS: �Vo �f�I�.tu✓ �a� u� Occupancy Type: Residential Commercial Other Permit Type: New or Replacement System, $100.00 Repair Existing System, $ 50.00 0.50 State surcharge added to above fees *See fee schedule for non-residential permit fees Owner's Name: Phone Number: Mailing Address: City;/ -. /n#z1—In Contractor's Name: PhoneNumber: q 7-7 4,>oy — Mailing Address: City: Tp: 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. L/ 1. I have received a copy of the system design including the City of Orono Septic System Approval Cover Sheet. 2. I will be installing the following: A. Tanks: _Precast Concrete _/Other Manufacturer Tank C cities: gal) 2) W gal. 3) gal. 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 Inside electrical work must be completed by electrician. C. Treatment System: I/ Trenches: 4 zD s.f. Mound Depth of rock below pipe J;,� _" Rock bed dimensions 'x ' Zjv Drop Boxes Sand bed dimensions 'x ' Distribution Box Pressure Dist. Pipe Diam. of Maniford Pipe Diam. to 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 ofApplicantr -r� ��n`/ D_o� Date: '57)1 MPCA Certification No.: Staff Review: Approval Denipl Reviewer: Date: l Reason for Denial: DATE TIMEyy CITY OF ORONO CALLED IN — INSPECTION NOTIC SCHEDULED PERMIT NO. COMPLETED ADDRESS AX U✓/—� OWNER CONTR. TELEPHONE NO. DESCRIPTIONalrz 41 01 FOOTING 11 MECHANICALRI 16 WELL TEST PUMP LL Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING LO03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS Z 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 J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP v 10 PLUMBING FINAL Q OWNERICONTRACTOR TO MEET YES NO Z y COMMENTS:cc /1 a J O O W c Q Z W W Or d ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE W Uj W ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY Q ❑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 ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473'7357 Owner/Contractor e: Inspector. White Copy/Inspector's File Canary Copy/Site Notice DAT TIME CITY OF ORONO CALLED IN Ii O INSPECTION NOTICE SCHEDULED PERMIT NO. COMPLETED _� ADDRESS OWNER CONTR. V /V TELEPHONE NO. DESCRIPTION 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING Ci 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS Z 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 v 07 DEMO—FINAL 27 AINT. 21 COMPLAINT 09 PLUMBING RI PTIC IN 22 FOLLOW-UP J 10 PLUMBING FINAL 23 SEPTIC AL OWNERICONTRACTOR TO MEET YOU: E NO ti CO 7ENTS: `//, P �' 1� h 5 (; a / 0 0 a 0 W cc Q 12 2 W W Woc WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE Uj ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY C1 BEFORECOVERING 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 advance.473-7357 Owner/Contra r"ID: Inspector. White CopyAnspectoes File Canary Copy/Site Notice CITY OF ORONO CALLED IN 1-1 INSPECTION NOTICE SCHEDULED PERMIT NO. COMP ETED ADDRESS I^ OWNER CONTR. SIr JV TELEPHONE NO. DESCRIPTION 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS Z 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 v 07 DEMO—FINAL 27 21 COMPLAINT 09 PLUMBING RI PTIC TA22 FOLLOW-UP 10 PLUMBING FINAL 23 SEPT FINAL Q OWNERICONTRACTOR TO MEET YOU: YES oy COMMENTS: cc LU ej,'cc (� o © ' V a r cc 0 UL W cc Q Z1. W Z W �OWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C 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 advance.473-7357 Owner/Contract Inspector. ZX,— White CopylInspector's File Canary Copy/Slte Notice CiTy6f O O NOo _ F PERMIT N. 3916 ' Building Permit DATE ISSUED Z7- 7f` AND APPLICATION FOR CERTIFICATE OF OCCUPANCY, EXPIRES P.O. BOX 66.CRYSTAL BAY, MN 55323 473-7 ;• ZONING DISTRICT SITE ADDRESS LEGAL DESCRIPTION:PROP.ID. FIRE ZONE LOT BLOCK SUBDIVISION WN (Ad s! (Phone) try Y� V T 3 l ARCHITECT/ENG) EER—Must Ca#ify Multi-Family,Commercial&Industrial Construction Plans CON6.USE DATE' ERT.NO. /V (FirffO (Address) (Phone) LOT AREA ER' Phone) `"�'�'lieiwvate CONSVALUATION'E T. ACCRIUMIDENTIA . ST ttEs e 1 s 3 PERMIT FEES !' BLDG.PERMIT NEW "EXISTING DWELL. eoRMsiFLR AGENCY•APPROV.DATE UNITS STATE FEE �► GE-D CIN GAR.STALLS SEPTIC ATT. APP.DATE PLAN REVIEW COUNTY DOCK PENALTY STATE NON•AESIO. PROPOSED USE PARK FEE SAC CHARGE CC �. PR.EASEMENT OLA CLASS. STORIES COUNCIL APP.DATE TOTAL DUE REMARKS: 9 � t r INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT FOOTING before pow SEPARATE PERMITS THE UNDERSIGNED HEREBY REOUESTS PERMISSION TO MA1 FRAMING roughdn INSULATION PLUMBING THE REAL IMPROVEMENTS SPECIFIED. AND DECLARt -WALLBOARD Before Taphq MECHANICAL UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEP �.IG..FINALbMeremupMev WELL ANCE OF ALL INFORMATION. CONDITIONS AND REOUIR SEPTIC MINTS REPRESENTED ON THIS DOCUMENT. THE UNDER WORK BEYOND OR WITHOUT ARE• SEWER SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT CON OU111ED INSPECTION WILL BE SUB• WATER ACT TO PENALTY. GRADING a FILLING PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STAT INSPECTION HOURS 473.7357 OF MINNESOTA BUILDING CODE REOUIREMENTS. CALL I.12 A.M.INSP.1.4 P.M. CALL 1. 4 PJA INSP.NEXT DAY ELECTRICAL from$ate . PZ44A Dow COPY. WHITI-FIbE , GREEN-FINANCE CANARY-INIPECTOR GOLD-RICEIPT PINK-ASSESSOR Appo vdiA dH of oror DATE / TIkIE CITY OF ORONO CALLED IN INSPECTION NOTIE SCHEDULED PERMIT N0. , ''V COMPLETED t ADDRESS T T'6(1 / t 4 11(11 Q�.__) I OWNER CONTR.. TELEPHONE NO. DESCRIPTION ---� 01 FOOTING_ ' 11 MECHAi 1CAL RI 18 EXCAV/GRADING/FIWNG 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q 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-UO 06 PROGRESS ~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT J �Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W cc J O 0; O W Cr Q Z W z W C j LQ _ WORK SATISFACTORY:PROCEED G PROJECT COMPLETE (t D CORRECT WORK&PROCEED D ISSUE CERTIFICATE OF OCCUPANCY W O D CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT D CORRECT UNSAFE CONDITION WITHIN HOURS. D PHOTO TAKEN INSPECTOR WILL RETURN D STOP ORDER POSTED.CALL INSPECTOR D CITATION ISSUED D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next' spection 24 hours in advance.473-7357 Owner/Contra o 't : Inspector. White Copylinspector's File Canary Copy/Site Notice