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Permits from 120 Brown Rd S
PERMIT CITY �F ORONO 2750 Ke�iey Parkway - PO Box 66 Permit Number: P08562 Crystal Bay, Minnesota 55323 Permit Type: Demolition (952) 249-4600 Date Issued: 4/4/2005 SITE ADDRESS: 120 Brown Rd S Long Lake,MN 55356 PID: 03-117-23-12-0005 DESCRIPTION: Proposed Use: Residential BuildingCensus Code 645 Permit Class: Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: I'ounuailons/all dein debris io be icniuveu fium ground OL disposed of off slfe per FCA regulailons. Wells m ist be abondoned. Inspection before backfilling. FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 50.50 APPLICANT: Green Acres Tree Service OWNER: Rick Carlson 6705 Hwy 12 464 2nd Street Independence,MN Excelsior,MN THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUI ING CODE REQUIREMENTS. r A C T PE A IS ED BY SIGNATURE Conies: 1-File(Siznitures Required), 1-Applicant, 1-Month1y Reports, 1-Assessing, 1-Finance Page 1 +t l CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT P.O. Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT General Instructions 1. You may be required to obtain other pennits, i.e. well abandonnunent, etc. 2. Work must not begin unless the permit card is available on the job site. 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. JOB SITE ADDRESS: -V Occupancy Type: _Residential Conunercial OWNER'S NAME: Phone; Mailing Address: Cit ' /�, �1 iJ/Jv CONTRACTOR'$NAME:�� -,,c e 4,1 4j gA .t�c, Bus.No.://(% �Vl q-//C- MailingAddress:, ���, City: /a ,2 Demolition if planned by means of: manual disassembly L--heavy equipment Permits Issued: j f #A,4`MVell Abandornnent .t a 5 73 8 In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is complete. 2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless specific prior approval is obtained in writing for temporary use thereof. 3. Foundations shall be completely removed from the ground. 4. All demolition debris shall be completely disposed of off site in accordance with all applicable PCA requirements. 5. Water wells must be abandoned in accordance with State Health Department regulations. 6. Inspection required when all debris has been removed, before backfilling. y 7. Within 5 working days of superstructure removal,a final inspection shall be requested. The site shall be left clean and clear of all debris,with any excavation filled with earth level with the adjacent ground elevation(except when such excavation is to be used as part of a new building and such new building is actually under construction). 8. The undersigned owner shall and hereby does indemnify and hold hannless the City of Orono, its agents, employees and assigns from and against all claims, damages, losses or expenses,including attorney fees,against the City,its agents,employees and assigns arising out of or resulting ftom the demolition described herein as performed by the property owner, his employees, agents, subcontractors or assigns. 9. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must be pumped,crushed and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are crushed and filled. PERMIT TYPE AND FEE CALCULATION _ $50.00 -Principal Structure $30.00 -Accessory Structure 1. Subtotal of above permit requested $ 2. State Surcharge $ .50 3. TOTAL PERMIT FEE (add lines 1-2 above) $ The undersigned hereby applies to the City of Orono for issuance of a Demolition 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. 1 APPLICANT'S SIGNATU .-, ate: OWNER'S SIGNATURE: Date: S oS' APPROVED BY: Date: 4 -1f 'd `. PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: P05951 Crystal Bay, Minnesota 55323 Permit Type: User Defined (952) 249-4600 Date Issued: 1/9/2003 SITE ADDRESS: 120 Brown Rd S LONG LAKE,MN 55356 (% ?ATE TIME CITY OF ORONOpL CALLED IN INSPECTION N ICE SCHEDULED' - = PERMIT NO. 0 COMPLETED ] ADDRESS OWNER CONTR. I 1 0 (j J Land Alteration(0-500 cu y( TELEPHONE NO. S a � _ �'S DESCRIPTION W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS ti 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 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT — J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J Z OWNER/CONTRACTOR TO MEET YOU:_YES NO COMMENTS: // ,L a �s t l)d iy"� S invi , t cc * -- a FI cc Sf0.00 0 cc Am, 0' �x1 W cc Q z W Z W Ad WORK SATISFACTORY:PROCEED 1 PROJECT COMPLETE VAN EECKHOUT ETAL cc C i C RRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY RD S LU O M RRECT WORK,CALL FOR REINSPECTION TEMPORARY N 55356 V BEFORE COVERING PERMANENT Cl CORRECT UNSAFE CONDITION WITHIN HOURS. r i PHOTO TAKEN INSPECTOR WILL RETURN i CITATION ISSUED STOP ORDER POSTED.CALL INSPECTOR SPECIFIED I; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. DANCES AND STATE OF Call for the next';inspection 24 hours in advance. (952) 249-4600 OwnerlContrac n 't i Inspector. - ;�lt White Copyllnspec"File Canary CopylSite Notice NATUIR r Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Month1y Reports, 1-Assessing, 1-Finance Page 1 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PER1MT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 00 ZIP: NAME OF OWNER: PHONE: (home) C)- _L q 7 3 ©V Z, — (work) MAILING ADDRESS: / ZO 5 CITY: LoWct L+uc ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detail): r/L(-- S-b 0 y/>s STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE• NOTE! Parade 12-t Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitte events will not be allowed. F .8 . Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)-the purpose and intended use of the requested data within the collecting State agency,political subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and;if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rightsstated above. Signature cl s", Ow wea, GENERAL PERMIT CITY PERMIT NO. 8163 CITY OF ORONO P.O.BOX 66 Date CRYSTAL BAY, MINNESOTA 55323 (612) 473-7357 Owner - �1 Address 1LQC) Contractor Address City License No. State License No. REMARKS AND SPECIAL CONDITIONS PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR Inside Plumbing (#fixtures_.) Fee $ Water Well Fee $ Water Meter (Size—) Fee $ Mechanical Equipment Fee $ Meter# Remote# Moving /Lifting Buildings Fee $ Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ 1:1 Copper ElGrading, Filling, etc.) Municipal Sewer Connection Fee $ _ Fire Fee $ ❑ PVC ❑Cast n Sprinkler System (Fire) Fee $ MWCC SAC Charge Fee $ Other: �� �ZI � Fee $ C On Site Septic System Fee $ After-the-fact Investigation Fee $ ACKNOWLEDGEMENT TOTAL The undersigned hereby acknowledges receipt of this limited permit, including acceptance of all special information, terms, conditions or requirements written above. The undersigned understands and agrees under penalty of law State Surcharge: Fee $ that this permit h activity orimprovem improvement specified that scope t this permit does .� not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ separate permit approvals; and that this permit does not grant authority to violate any provision of any City ordinance or State law,rule or regulation. All work shall be done in strict compliance with all City ordinances,building codes and/or health department regulations, and shall be This permit is not valid until the proper fee is paid and subject to inspection, approval or rejection by the City. it is approved by an authorized City Official. Whenever so ordered, the undersigned agrees to correct any work found to be in violation of the conditions of this permit. Signature of Applicant Signature of City Offici j Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy old—Applicant's Receipt 3 HC5330(6/00) HENNEPIN COUNTY Transportation Department 1 6�\ 1600 Prairie Drive-Medina,MN 55340-5421 Permit No. r DRIVEWAY OR STREET ENTRANCE PERMIT AND SPECIAL PROVISIONS Field inspected by Dave Zetterstrom Date 1111012004 Location # 146 120 Brown Road Speed zone 45 A.D.T 1650 Nearest Cross Street(if rural) Sight distance:.Actual-Left 635+ Right 570+ Minimum-Left 635 Right 57u Curb to be removed to: ❑ Construction Joint ❑Sawed Joint Recommended drainage: ❑ Surface ❑XCulvert Culvert length Culvert diameter 1.CONSTRUCTION SPECIFICATIONS(Within Right-of-Way) BASE SURFACE CURB SIDEWALK SHOULDER BLVD-DITCH Type Per Type Per Type None Type Type Match Topsoil X Depth Plan Depth Plan Design Depth Depth Fisting Depth +seed or sod 2.TRAFFIC CONTROL REQUIREMENTS Per MMUTCD 3.SPECIAL PROVISIONS One private street entrance permitted as revised per plan dated 12/02/2004. Applicant to provide and maintain"STOP"sign. DO NOT PLACE CONCRETE ON COUNTY RIGHT-OF-WAY WITHOUT WRITTEN PERMISSION. IF YOU HAVE ANY QUESTIONS, CALL (763)745-7643. Diagram A I Diagram B R/V11 IMPORTANT: TYPE"a"CONSTRUCT ROUNDED BERM TO C/L IMPORTANT: CONSTRUCT SWALE TO DIVERT WATER FROM RNV PREVENT WATER FROM RUNNING DOWN SHOULDER. I DRIVE. 2"Gutter 6"Swale { oriveVV M ,.a,OrivewaV .� •.. •, , •r ; . .. •r.,... Existing Roadway t Shoulder Shoulder } Place culvert in existing ditch Final inspection date APPROVED/DENIED: Driveway was found to be ❑ Satisfactory HENNEPIN COUNTY Transportation Dept. ❑ Unsatisfactory Inspected by By Date e^c'-"f5 �fRs�'.h.:;�*'.'at9^�c:;ai�".'a„-rs•.,s4.,,�„r, ,,,. :. .. 'a' ^s�'�> a�e,vr-*,.tea �Q.•+P'.F :�.ms�s�*s��:,.^ .. ..., .. ..r Curb Gutter DRIVEWAY �/�"Expansion Jt.-- • 1/2" Expansion Expansion Joints at 60'IApprox):: .''.!: Expansion A. Joints - maximum interval. } -j 4"Walk Q 1/2" 6"Walk Expansion Jt Expansion U1 Joints Square Panels 4' Walk Contraction AL CL Private Walk, Curb and Gutter 8" Pav't. 6" Pav't. ivate Driveway Paved A I ley ?77imT-r" 4"Walk 4"Walk 4"Walk Contraction Joints Prov ide interned iate jo int at 1/4" R. 1/4" per Ft. slope toward roadway squared end in sidewalk vvhen T r sidewalk Is adjacent to curb ; �> .. . . and gutter. � co 4%6" .� Variable Width SECTION THRU WALK CONCRETE WALK 4"Walk 01 00, 45' C & G w .yw 600 to 40o s/0Ae 3' 01 4" R Drivevey Pavement 1/4"R. Variable 1 en9th ries S/oAe Ate/ a.. a 5-1 OX.des iraM! 1516 wx. diff. HC 5330 back(3/93) r HC 5329(6/98) HENNEPIN COUNTY ENTRANCE Transportation Department Permit No. PERMIT FEES Planning Division 1600 Prairie Drive PRIVATE $50. Medina, Minnesota 55340 TEMPORARY $100. COMMERCIAL $200. APPLICATION FOR DRIVEWAY OR STREET ENTRANCE PERMIT STREET $200. (Read "General Requirements" reverse side) Name of applicant It; r 11 64iu Phone Address LO_ ?Si Cvtrtr � JV (city) r (state) (zip code) Name of Property Owner !'`PPE?:, >c �ea�;=y� 11��t,� i : ' Address il/],,1�dr r f1: 4,1, 1. Contractor performing work (If Known) Phone 2. Application is hereby made for permission to construct and thereafter maintain: Driveway(s) Public Street(s) 3. Building to be constructed: 11 Yes El No El Residence EJ Commercial (Specify Type) 4. Driveway or street will be: El Temporary 11 Permanent Date proposed entrance will be needed: 5. Is the property: El Platted 1-1 Unplatted Number of present driveways or entrances to property: 6. Building Permit acquired: EJ Yes 0 No City Permit No. 7. Type of proposed entrance surface. El Bituminous El Concrete 0 Rock El Other 8. Location (Address) (Co. Road) (City) 9. Location, if rural: Miles of (N.,S.,E.,or W.) (Road or Street) Dated Applicant's Signature Printed Name TO HELP THE INSPECTOR, PLACE A STAKE WITH A CLOTH ATTACHED IN THE CENTER OF THE PROPOSED ENTRANCE, HIGHER THAN ANY SURROUNDING VEGETATION. APPLICANT'S DIAGRAM - (If plot or construction plan is not submitted) Complete this form and send all copies to: Hennepin County Transportation Department, Planning Division, 1600 Prairie Drive, Medina, Minnesota 55340. Phone: (612) 745-7643, FAX: (612) 478-4000.After approval, one copy will be returned to applicant. HC 5329 back Applications for commercial and industrial driveways or driveways servicing parking lots or garages with five or more vehicular parking spaces must be accompanied by two (2) separate layouts. Such layouts must meet the requirements of the Rules and Regulations Establishing Design Specifications for Driveways along Highway Systems of Hennepin County, Minnesota.Copies are available at the Hennepin County Transportation Department, Planning Division,1600 Prairie Drive,Medina,MN 55340. 2, Applications for entrances serving private residences, farms or parking lots of less than five vehicular parking spaces need not submit a site plan,but shall make an appropriate sketch in the space provided on the front of this form.Such sketch shall generally locate the entrance,indicate its dimensions and relate to property lines. 3. No work shall be started until the application is approved and the permit issued. 4. If the installation of this driveway makes it necessary to work on the roadway, traffic must be protected; lights signs and proper barricades must be in place. 5. It is expressly understood and agreed that this permit is conditioned upon not placing any materials on the traveled portion of the County roadway and that restoration of all disturbed areas becomes the responsibility of the applicant.The areas disturbed must be restored to their original or a satisfactory condition. 6. After driveway construction is completed,persons requesting the installation must notify the Planning Division that such work has been completed and is ready for final inspection and acceptance by Hennepin County. 7, No changes or alterations in entrances may be made at any time without written permission from the County Engineer or Representative. $, Approval of this permit does not deny the County Engineer the future right to revise,relocate or close any entrance to expedite the movements of vehicular or pedestrian traffic.The County retains the right to close said entrance(s) at its discretion,based upon the necessity for traffic regulation and control. $. Existing driveways are not automatically perpetuated. In th event of a change in land use or a major change in the traffic pattern of the existing facility,new driveway applications may be required by the County. LS U ,, N � 7 SURMOUNTABLE 331 CURB & GUTTEF 33BEGIN CONC CURB & GUTTER, STA 0+67.22 � 2+DO ©Ln 1 Ln co, m REMOVE EXISTING N x y 15" CMP CULVERT 18' WIDE z APRON CE 0 STA=1+13 A SAWCUT EXISTING MINOUS BEGIN CONC CURB E TO EDGE OF DRIVE LANE. Q & GUTTER, STA 0+30.79 / MATCH 1NT0 EXISTING �"` �+ 30'R # BITUMINOUS SURFACE O CURVE � °� o = 22 10o k---- m L = 40 cn PC = 1 PT 1 33. o -33, d � � r N w u. z W I 0 Vol\ CITY of ORONO Municipal Offices � t Street Address. Mailing Address: ESHO�/ 2750 Kelley Parkway P.O. Box 66 Orono, MN 55356 Crystal Bay, MN 55323 0066 September 25, 2000 Charles VanEeckhout 120 Brown Road South Long Lake, Mn 55356 Dear Mr. VanEeckhout: An inspection of your septic system was conducted on September 18, 2000. A summary of the inspection is below. Septic Tank Condition 1. Pumpout not needed at this time. The septic system is non-compliant due to a lack of a three foot separation distance between the bottom of the drainfield to the seasonally high watertable. The three foot requirement is a State Code,not a City Code. A soil boring was conducted to determine the depth of the seasonally watertable. The septic system must be replaced by December 31,2010. Enclosed is a list of state licensed septic contractors who work in Orono on a regular basis. Also enclosed is a fact sheet explaining how a septic system functions properly. Finally, an as-built drawing is enclosed that shows the approximate location of the septic system. If you have any questions regarding this report, please contact me at the City Offices at 249-4600. R pectfully, I 7 /A, ris Pence On-Site Systems Manager Enclosures In the event this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does no guarantee or certify the existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with the system location and pumping records. Telephone(952)249-4600 • Fax(952)249-4616 www.ci.orono.mn.us -eVN_ CITY of ORONO Municipal Offices tiG Street Address: Mailing Address: 2750 Kelley Parkway P.O. Box 66 Oro-no, MN 55356 Crystal Bay, MN 55323-0066 Owner: L'h ` �� C!J'LI ou 1 Address: 120 Brown Rd. S. Permit #'s: 2855, 2796 Dates: 9/13/71, 7/27/71 Contractors: Peterson, Murphy Plbg. (This is [)�,] an existing system [ ] new construction) . SYSTEM COMPLIANCE (1-3) : 1 Code System: Meets or exceeds current City standards in all respects relating to design, construction, and location. Appears to be operating properly. 2 Compliant System: Does not meet all current City standards for new construction, but in most respects appears to be designed, located, and constructed in accordance with previous codes and is functioning properly. 3- Non-Compliant System: System may or may not meet current City standards for design, L construction, or location, but is failing to properly treat and dispose of the current input; and any system with less than three feet of vertical separation between the bottom of the drainfield and the saturated soil level. (The saturated soil level is [ �] or is not [ ] identified under this septic system. If the saturated soil level is not identified, this classification is subject to revision.) TANK CONDITION (5-9) : 8; 5 Pumpout not neede at this time. 6 Solids accumulation in tanks indicates they should be pumped out this year. 7 System is discharging to the surface. Tanks must be pumped out within 48 hours. 8 Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out `- within three years, they should be pumped out and risers installed now. 9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks have not been pumped out within three years, they should be pumped out now. 10 One or more tanks are cesspools, which means the septic system is non-compliant. (The tanks are [ ] or are not [ ] water tight or the condition is [�/] unknown. If the tanks are not confirmed to be watertight, this classification is subject to revision.) ,a&AINFIELD CONDITION (11-14) : `11,' Drainfield is dry, no surfacing evident. 12 Some evidence of surfacing, not critical yet. Repair is not required at this time. 13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately. Repair must be completed within 90 days. 14 Drainfield extent and condition unknown. POTENTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc. ) : medium COMMENTS: The septic system is non-compliant, but does not appear to pose an imminent threat to public health or safety (surface discharge or backup into the dwelling) . The system must be repaired or replaced by 12/31/2005 or within ninety days of posing an imminent threat to public health or safety, whichever comes first. Date of Inspectionis System Inspe for If-Note: In the event that this inspection report is used to satisfy the requirements for a transfer of property, this report does not guarantee that an existing system will continue to function properly, but indicates the operation of the system under current conditions. Telephone (612) 473-7357 9 FAX 473-0510 CITY OF ORONO � O O Municipal Offices O Post Office Box 66 Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT r� INSPECTION REPORT �kts 0 Owner: !�Y4<t 11�CLIa Address: Z I -d� Permit #'s: Dates: Contractors: /� � �� , tsor-\ City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis. The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked below. (This is✓4 an existing system l ) new construction) SYSTEM CONFORMITY (1-3): 1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input without discharging any pollutants into ground or surface waters. 2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the current City Codes, but was installed according to the code in effect at the time of installation, and which is operating satisfactorily by treating and disposing of the entire current sewage input without discharging any pollutants into ground or surface waters. 3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any system wh ch may or may not meet all the Location, design, and construction standards of the current City Codes and which is failing for any reason; and any system with Less than 3 feet of unsaturated soil or sand between the distributionevice and the limiting sot c aracter sttcs:-�--•_ -- - - - - --__ -. � ) rt J (The limiting soil characteristic i c has or [ ] has not been identifi a this time If the Limit ing soil --)(-characteristic has not been idents ied, this classification may be subject to revisio .) i W C5 1p):indcates:ot neded at this time. cumuation in tanks indicates the io help prevent future problems. cumu§tion in tanks is at a critica level. Tan sshouldbe pumped out as soon as possible. disoarging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge. 9 Inspecin ri�rs missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each tank atiext pumpout. If tanks have not been pumped out within the last three years, they should be pumped out now. 10 inspection piI is located directly over tank baffle (does not give accurate measurement of solids accumulation). If tank�have not been pumped out within the Last three years, they should be pumped out now. rD,,.RAINFIELDN)ITIOKI1-14)slectio indicates: eli is iy, no surfacing evident. id,nce i surfacing, not critical yet. eli is aturated and visibly discharging untreated effluent to the surface. Contact the City Inspector mmdiatcy. Repairs must be completed within 90 days. 14 Drainfielcextet and condition unknown. LIMITING SITE FA ORS'slope setbacks etc.): POTENTIAL FOR SY:EM FILURE (depends on soils water table etc ): OMMENTy�: i jh r tiS if " `� `(i� 1A IM, wr4p DlteOpection Sgrptic System lnlspector Note: in the event th.his inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised tithis report does not guarantee or certify that an existing system will continue to function properly, but is mereln opinion of the adequacy of the system under current conditions based on the available Information. This rt- must be kept on the premises with the system Location and pumping records. E COPY/Inspectors File YELLOW COPY/Homeowner CITY OF ORONO 0 Municipal Offices O O Post Office Box 66 Crystal Bay, MN 55323-0066 ON-SITE SEWAGE TREATMENT INSPECTION REPORT ti ESHO4�G Owner: _ l,Er��/Il°S Address: 1,20j��i7,,,rti , S Permit #'s:! Dates: F-13-21 �7;, L-71 Contractors: �O�^/////M �,( 7,�? City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis. The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked below. (This is J4 an existing system [ ) new construction) SYSTEM CONFORMITY (1-3): 1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input without discharging any pollutants into ground or surface waters. "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the current City Codes, but was installed according to the code in effect at the time of installation, and which is operating satisfactorily by treating and disposing of the entire current sewage input without discharging any pollutants into ground or surface waters. 3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any system which may or may not meet all the location, design, and construction standards of the current City Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics. (The limiting soil characteristic [ ) has or has not been identified at this time. If the limiting soil characteristic has not been identified, this classification may be subject to revision.) TANK CONDITION (5-10): Tank inspection indicates: Pumpout not needed at this time. 6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems. Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible. 8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge. 9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each tank at next pumpout. If tanks have not been pumped out within the last three years, they should be pumped out now. 10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation). If tanks have not been pumped out within the last three years, they should be pumped out now. DRAINFIELD CONDITION (11-14): DrjpKinfieLd inspection indicates: 19 Drainfield is dry, no surfacing evident. Some evidence of surfacing, not critical yet. 13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately. Repairs must be completed within 90 days. 14 Drainfield extent and condition unknown. LIMITING SITE FACTORS (slope,setbacks,etc.): POTENTIAL FOR SYSTEM FAILURE (depends on soits,water table,etc.): COMMENTS: - A Date of Inspection ptic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised that this report does not guarantee or certify that an existing system will continue to function properly, but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with the system Location and pumping records. WHITE COPY/Inspectors File YELLOW COPY/Homeowner On the North Shore of Lake Minnetonka ON-SITE SEWAGE TREATMENT CITY INSPECTION REPORT OF POST OFFICE BOX 66 1335 S. Brown Rd. O_ONO Crystal Bay, MN 55323 Ilk 473-7357 OWN ER //a✓/ ��Y? P��IY�JT CADDRESS PERMIT NO.'S. DATES Zai J�7� / ���� CONTRACTORS City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on site sewage treatment system at the above address has been inspected and appears to fall into the category checked below. (This is 9d an existing system ❑ new construction) 1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating properly. 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed, located, and constructed generally in accordance with previous codes. System appears to be functioning properly;no major upgrading of the system is required at this time. ❑ 3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time. 4 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and dispose of the current input,and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is creating a safety hazard, or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary, soil testing will usually be required,and a design and site plan must be submitted for review.Your contractor must obtain a permit before work is started. SYSTEM CONDITION ( lZ Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not ❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they should be pump• have not been pumped out within the last three years, they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates: should be pumped out as soon as possible. Q Drainfield is dry,no surfacing evident. El System is discharging to surface. Tanks must be pumped Some evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace- Inspection risers (4" dia, pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days. the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown. SITE CHARACTERISTICS: Limiting Site Factors Potential for System Failure Site Capabilities for ❑ Slope (depends on soil types,water Future Expansion ❑ Soil table,and system condition) ❑ Adequate ❑ High water table U Low Pt Fair ❑ Lot size ❑ Medium ❑ Poor ❑ Lake,wetland,or stream ❑ High ❑ Inadequate ❑ Drainage ❑System is causing visible surface discharge. ^ � COMMENTS: ' J.LL �' I >Jt=f'✓_� .� Y�/+-� yGI!? n^ 4P Date of Inspection Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with system location and pumping records. WHITE COPY/Inspector's File GOLD COPY/Homeowner On the North Shore of Lake Minnetonka ON-SITE SEWAGE TREATMENTCITY INSPECTION REPORT OF POST OFFICE BOX 66 O_ONO 1335 S. Brown Rd. Crystal Bay, MN 55323 473-7357 '!X� - �l�!.Si �,i?1 Il ����C �c%�J; U+..�.f�1 �"„i:;'1 /_' i'i� �� i'f '✓,'� OWNER ADDRESS 7� ; PERMIT NO.'S. `�` t 1 h DATES 3 CONTRACTORS City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked below. (This is I' Z an existing system ❑ new construction) 1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating properly. 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed, located, and constructed generally in accordance with previous codes. System appears to be functioning properly; no major upgrading of the system is required at this time. ❑ 3 Does not meet current City standards in many respects relating to design, construction, or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time. F-14 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and dispose of the current input, and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is creating a safety hazard, or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary, soil testing will usually be required,and a design and site plan must be submitted for review.Your contractor must obtain a permit before work is started. SYSTEM CONDITION ( (0 Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle. (Does not ❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drainf"eld inspection indicates: should be pumped out as soon as possible. Drainfield is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated Irtiorz risers mis�—tanks could not be inspected. effluent to the surface. This condition may require replace- fnspection risers (4” dia. pipe)must bainsta"d-imeaeh-tank ment or additions to drainfield. Contact the City Inspector at-next-,puasp©ut. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days. the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown. SITE CHARACTERISTICS: Limiting Site Factors Potential for System Failure Site Capabilities for ❑ Slope (depends on soil types,water Future Expansion ❑ Soil table, nd system condition) /6'7(Adequate ❑ High water table Low ❑ Fair ❑ Lot size ❑ Medium ❑ Poor ❑ Lake,wetland,or stream ❑ High ❑ Inadequate ❑ Drainage ❑ System is causing visible surface discharge. COMMENTS: Date of Inspection Septic S to 'Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with system location and pumping records. WHITE COPY / Inspector's File GOLD COPY/Homeowner On the Nortb Shore of' Lake Minnetonka ON-SITE SEWAGE TREATMENT CITY INSPECTION REPORT POST OFFICE BOX 66 � _ � � 1335 S. Brown Rd. Crystal Bay, MN 55323 473-7357 OWNER ADDRESS /1 C% obIZOWL R12 J g SS -13— 7 Sv.v PERMIT NO.'S. -27`&, DATES -7`_i7— 7t CONTRACTORS City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked below. 1-1 (This is 0 an existing system ❑ new construction) F11 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating properly. 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed, located, and constructed generally in accordance with previous codes. System appears to be functioning properly; no major upgrading of the system is required at this time. ❑ 3 Does not meet current City standards in many respects relating to design, construction, or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time. 4 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and dispose of the current input, and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is creating a safety hazard, or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary, soil testing will usually be required,and a design and site plan must be submitted for review.Your contractor must obtain a permit before work is started. SYSTEM CONDITION ( [Z Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle. (Does not ❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks — Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates: should be pumped out as soon as possible. ❑ Drainfield is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated ❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace- Inspection risers (4" dia. pipe) must be installed in each tank ment or additions to drainfield. Contact the City Inspector at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days. the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown. SITE CHARACTERISTICS: Limiting Site Factors Potential for System Failure Site Capabilities for -❑ Slope (depends on soil types,water Future Expansion ❑ Soil table,and system condition) —---❑ Adequate 11 High water table ❑ Low ❑ Fair Lot size --❑ Medium ❑ Poor �❑ Lake,wetland,or stream ❑ High ❑ Inadequate ❑ Drainage ❑ System is causing visible surface discharge. COMMENTS: Date of Inspection Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with system location and pumping records. WHITE COPY/Inspector's File GOLD COPY /Homeowner O : O CITY of ORONO Municipal Offices 'a G Street Address: Mailing Address: 2750 Kelley Parkway P.O. Box 66 Orono, MN 55356 Crystal Bay, MN 55323-0066 95a-Z49-4600 pp pp� To Current Owner: Address: (1cUXrr\ City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years. The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below. SYSTEM CONFORMITY (1-3): 1 "CODE SYSTEM" An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code. 2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono Municipal Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and which is not failing or an imminent threat to public health or safety. O "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics. TANK CONDITION(5-10): Tank inspection indicates: 5 Pumpout not needed at this time. © Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years. Tank was last pumped I-I Z- `�'`l ). Make sure septic tanks are pumped through manhole and not through white inspection pipes. This allows for the proper cleaning. 7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. DRAINFIELD CONDITION(11-141: Drainfield is dry,no surfacing evident. 9 Some evidence of surfacing,not critical yet. 10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately.Repairs must be completed within 90 days. COMMENTS: S-fS�c.- r�.�SX1�,� �) 1�=31- Zo10_ or C o.r,� i �.- c,c�\�S �G— tc ��lv L f\Li— �;(.•. c���� -D-'A', Date of Inspection Matt Bolterman - Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. CITY of ORONO Municipal Offices lit A ; Street Address: Mailing Address: \ �9B2750 Kelley Parkway P.O. Box 66 kzS0 �' Crystal Ba MN 55323-0066 Orono, MN 55356 y, To: The Current Owner of Address / 2 o G rc)cJ tJ S City Ordinance requires that onsite sewage treatment systems in Orono be inspected on a periodic basis. The onsite sewage treatment system at the above address has been inspected and the following is known about the system. A sketch of the known components of the system is available for most properties at the Orono City Hall. Imminent Public Health Threat Yes No If yes, please contact the Onsite Systems Manager at 952-249-4626 within 10 days of receipt of this notice. The septic system must be brought into compliance within 90 days. Failure to do so will result in referral to the City Attorney for legal action. System Identifi as Non-Compliant Yes No If yes, system must be brought into compliance by: December 31, 2007 December 31, 2010 Other Septic Tanks ump out Needed Yes No The City recommends the septic tanks) and/or lift tank be serviced and pumped out every three years. City records indicate the tank(s) were last pumped out on 1 - 9'�- - `? c, . The tanks) should be cleaned through the manhole and not through the inspection pipes, this allows for proper cleaning. Comments: Inspector: Date of Inspection ' (D(0 Telephone(952)249-4600 - Fax (952)249-4616 www.ci.orono.mn.us o� O CITY of ORONO Municipal Offices fit, i•i;''" t � G Street Address gS3-a49-y60 O Mailing Address: '9xxp4�� 2750 Kelley Parkway P.O. Box 66 Orono, MN 55356 //Crystal Bay, MN 55323-0066 To Current Owner: Address: ��4 8ro\W-r\ , s City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years. The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below. SYSTEM CONFORMITY (1-3): 3 1 "CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code. 2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono Municipal Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and which is not failing or an imminent threat to public health or safety. 0 'NON-CONDLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics. TANK CONDITION(5-7): 6 Tank inspection indicates: 5 Pumpout not needed at this time. (6l Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years. `l Tank was last pumped Make sure septic tanks are pumped through manhole and not through white inspection pipes. This allows for the proper cleaning Keep water softner and iron filter discharge out of septic system to prolong life of drainfield. Ask pumper to test alarm float to verify alarm is still working in your house The alarm warns owner that septage is about to backup into basement. 7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed to each tank. If tanks have not been pumped out within the last three years,they should be pumped out now. DRRAINFIELD CONDITION(8-10): (s 1 Drainfield is dry,no surfacing evident. J Some evidence of surfacing,not critical yet. 10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately.Repairs must be completed within 90 days. ca,�.�-. 1 _ _.;S �o� -Lo^- 1;^^� d- 1t"yS.j- �t 6•� �4LcJ COMMENTS: Q t 6 12=11 — Zolo Date of Inspection Matt Bolterman - Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised that this report does not guarantee or certify that an existing system will continue to function properly. but is mercly an opinion of the adequacy of the system under current conditions based on the available information.