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HomeMy WebLinkAbout2017-00501 - Mound Septic - new/replacement CITY OF ORONO 1 7 - 0 0 5 0 1 2750 KELLEY PARKWAY DATE ISSUED: 06/05/2017 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS 500 WILLOW DR S PIN 03-117-23-32-0017 LEGAL DESC N/A LOT 001 BLOCK 001 PERMIT TYPE SEPTIC PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE SEPTIC(NEW OR REPLACEMENT) ACTIVITY SEPTIC(MOUND) NOTE: MOUND SEPTIC SYSTEM 3-PRECAST CONCRETE 1500 GALLON TANKS APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 TOTAL 400.00 MATTER EXCAVATING Payment(s) 3710 CO. RD 21 CHECK 5056 400.00 MAYER,MN 55360- (612)644-4587 Minnesota State License#:sept-L302 OWNER MERRY,GRAHAM 3750 HUNTINGTON AVE S ST LOUIS PARK,MN 55416- 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 _ revoked at any time for due cause. pp icant ermitee Siknature Date Issued By Signature Date City of Orono FOR CITY USE ONLY O P P.O.Box 66 2750 Kelley Parkway Date Received: E�5 i Crystal Bay,MN 55323Permit# i b C,c` F . Phone:(952)249-4600 �KtSROak Fax: (952)249-4616 Approved By: x"i!!�j Amount$: CITY OF ORONO -SEPTIC SYSTEM PERMIT APPLICATION (All permits must be approved by the On-Site Septic Manager and/or Building Official) Site Address: `� l�/� I tom r Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor/App: _Mae,- Contact Person: �;� (\ ei Address: 7 7t G State License #: 1 36,)_ City: _rncu��/ Zip: Expiration Date: ��- r Phone: Alternate Phone: XResidential ❑ Commercial ❑ Other WPUeVNT Fill in all roriate blanks and check ali appro #e boxQs. Tanks: Precast Concrete ❑ Fiberglass ❑ Plastic ❑ Other: Number of Tanks: 3 Size of Tanks: __'4.'500 1500 Type of Activity: ❑ Trenches Mound ❑ Pressure Bed ❑ Chambers ❑ Holding Tanks ❑ Pre-Treatment ❑ Other NOTE: Provide an As-Built of the system before the final inspection. A 24-HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. Page 1 New or Replacement System $400.00 Repair Existing System 100.00 (Tanks or Drainfield) Total `f�`O� 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 Date: MPCA License No.: oa - Staff Review: A pt D Hied Reviewer: Date:_ Reason for Denial: Comments (to be printed on inspection card): 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. *** DO NOT MAIL PAYMENT WITH THIS APPLICATION *** 2. Permits will be only issued to contractors holding a Minnesota Pollution Control Agency (MPCA) Septic System Installers License. 3. All work must be done in accordance with the approved septic system design. 4. The following inspections will be required for all septic systems: A. Tank installation prior to covering. B. Drainfield trench installation prior to covering. For mounds, inspection is required after rough up, but prior to sand placement (sand must be jar tested for silt content) and again during pressure distribution piping installation in the rock bed. C. Final inspection to verify final cover depths and to verify that all pump station (where required) components are functional and comply with codes. 5. MPCA licensed Installers or their DRP (Designated Responsible Person) shall be present during all inspections. Page 2 DATE TIME CITY OF ORONO CALLED W INSPECTION NOTICESCHEDULED PERMIT NO. K01 -03201 COMPLETED ADDRESS���ilp /�1y(IiI OWNER TELEPHONE NO. CONTRACTOR DESCRIPTION ��LAI ek-ol t��t�� Ay ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING 0 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP [3FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE SEPTIC INSTALL A OWNEWCONTRACTOR TO MEET _YES_NO COMMENTS: cc ac - 71 o; W ' Q o tr J W ❑WORK SATISFACTORY:PROCEED O PROJECT COMPLETE W RRECT VMORK E PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN El GTATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR El INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours In advance. (952) 249-4600 Ownw#Ccx*sytw on site: Inspector: white CopyAnspeetoes Fille, Conry CopyyBla Nota vl� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMfr NO.z o 17 - ©ay 9( COMPLETED L 'L d ADDRESS 300 hA 110Z, '/ OWNER TELEPHONE NO. CONTRACTORS <//� DESCRIPTION -7-el- 0 e-❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ DEMO-SITE EPTIC INSTALL J Z OWNERlCONTRACTOR TO MEET YES_NO c COMMENTS: 0 0 W cc Q 2 W Z W Qr J W ❑WORK SATISFACTORY PROCEED ❑PROJECT COMPLETE CC ❑CORRECT WORK S PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN EI CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerfCon on site; Inspector. �� White Copynnspector's File Canary CopyMe Notice �rz DA E TIME CITY OF ORONO CALLED IN INSPECTION NOTICEC� SCHEDULED ` PERMIT NO. r) COMPLETED ADDRESS ow rN 7� / /yi j OWNER TELEP N O. a �G & "f 7 CONTRACTOR "-g DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL r ❑ DEMO-SITE SEPTIC INSTALL 2 OWNERICONTRACTOR TO ME U:_YES_NO «� COMMENTS: W a ,0 0 �� o� Q i W W J Cl WORK SATISFACTORY:PROCEED C1 PROJECT COMPLETE 0: 0 WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Ci 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. (952) 249-4600 r on site: Inspector it, Copyllnspectoes File Canary Copy/Site Notice Y TE TIME CITY OF O ON CALLED IN /. INSPECTIONTIC �.C�/ SCHEDULED — PERMIT NO. COMPL ADDRESS 7 OWNER TpihEPHONE NO. "4v / CONTRACTOR DESCRIPTION C t~N ❑ FOOTING ❑ DEMO-FINIL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL ..1 [I DEMO-SITE El SEPTIC INSTALL 2 OtIWNEWCONTRACTOR TO MEET YOU:_YES_NO COMMENTS: lf� Kn ctd ry W OC J W KSATISFACTORY PROCEED ❑PROJECT COMPLETE a !00 CO ECT WORK 3 PROCEED ClISSUE CERTIFICATE OF OCCUPANCY CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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. (952) 249-4600 OwnerlContra site: Inspector: White Copyllnspectoes File Canary Copy=*Notfee C J DA TIME CITIY ARONO CALLED IN / / INSPECTION NOTICE / SCHEDULED PERMIT NO. ✓ COMPL r ADDRESS OWNERT�E ON NO. CONTRACTOR DESCRIPTION 12 ded hC ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 O'WNERICONTRACT�ORRTTO MEET YOU:_YES No 2 COMMENTS: + r- , e,/e, 4 j O Q Q,�}'[C, S�X��[.�t � S CB�'ti►�?�(I��' yV;•�L. ('�LcI,�•�[n i76g 0 <0aes� � W a _ �-A W ❑WORKSATISFACTORY PROCEEDXPR�OJECTCOMPLETE w ❑CORRECT WORK A PROCEED / ❑IIIuE CERTIFICATE OF OCCUPANCY C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN Cl CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 on site: Inspector White Copylinspectoes File Canary Copy/Site Notice