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�` Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(p[ease print all information)
------------------------------------------------------------------------------------------------------------------------
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR�
, �_.,�...._.z_
JOB SITE ADDRESS: ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ NO Ifyes, a special event permit is required with Police Department and Ciry Council approval
60 duys prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non-permrtted events will not be allowed.
NAME OF OWNER: ���� PHONE: (home) �/-�-1 �`�
�
(work)
MAILING ADDRESS: CITY: ZIP:
Renewal By Andersen
CONTRACTOR: 1920 County Road "C" West PHONE:
CONTACT PERSON: Roseville, MN �5113 AGER:
MAILING ADDRESS: _ I,icense #20130983 ZIP:
STATE LICENSE: # 651-264-4777 DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth mov t ay require MCWD review and permits !
PROPOSED WORK(describe in detain. G�,�`�
ti r
,
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
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 ofthe City and with the State Building
Code;that I understand this is not a pe mit and work is not to start without a permit;and that the work will be
in accordance with the approved p
APPLICANT'S SIGNATU TE: �
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. I. Type of data. The rights of individual on whom the data is stored or to be srored 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 himselfshall 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.
I'he commissioner oY revenue mav 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. Afrer an individual has becn shown the private data and informed of its meaning.the data need not be disclosed to him for six
months thereafrer 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 priva[e or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person ro pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant ro this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possibie. 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 comp►eteness of public or private data
concerning himselt To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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,induding recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be disclosed oniy 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
conrested 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 far 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.
Your full name is required to r cess this application it.
Fir `C Jl.J Mid e � Last
�
ddress
S � � �I�(.d�
C�4' State Zip Phone
I understand my rights s stated above.
Signature
Reset Form 32
CITY OF ORONO DATE �
INSPECTION NO ICE CALLED IN TIME
PERMIT NO. /��j 7 SCHEDULED � --�
P11258
ADDRESS 7?�� COMPLETED �Z-I �
�/9�yf��( /1 �_ Addition/RemodeURepair
OWNER f Lo
8/9/2007
TELEPHONE NO. CONTR.
� DESCRIPTION
� 01 FOOTING /���� U�-C.Cl�y.Q.��
Q 02 FRAMING �� MECHANICAL RI
y 13 MECh4qNICAL FINAL �$ EXCAV/GRADING/FILLING
Z03 INSULqTIpN 19 LAKESHORE/WET�qNDS 1p1riC}� R3
04 Wq��gp 24�25+�/OOD BURNER/FIREPLqCE 34 TREE REMOVAL
Q OS FINAL 72 WATER HOOK-UP
►� 07 DEMO-SITE
14 SEWER HOOK-UP �� SITE INSPECTION ion Type VN
Q �7 DEMO-FINAL 27 SEPTIC MAINT. 06 PROGRESS
? �9 PLUMBING Po 75 SEPTIC INSTALL. 21 COMPLqINT Ode 434
�� PLUMBING FINAL 23 SEPTIC FINAL 2z FOLLOW-�p
� 35 HARD COVEFt REMOVAL �-type(s): DeCk-AttaChed
Q �WNER/CONTRACTOR TO MEET YOU:_yES
�= 36 FOUNDATION/REMOVq�
COMMENTS: —No
W
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W WORK SATISFACTORY:PROCEED
W ❑CORRECT WORK&PROCEED �OJECT COMPLETE
� ❑CORRECT WORK,CALL FOR REINSPECTION 'aluation: $ 8,100.00
-- ISSUE CERTIFICATE OF OCCUPqNCY
C� BEFORE COVERING
❑CORRECT UNSAFE CONDITION WITHIN �TEMPORqRy
INSPECTOR WILL RETURN �HOURS. �—PERMANENT
❑STOP ORDER POSTED, � PHOTO TAKEN
❑ INSPECTfON REQUIRED.CA�TO ARRANGE ACCESS. 17 CITATION ISSUED
Call for ihe t inspection 24 hours in advance. � 249-4
Owner/Contrac 952) 600
Inspect .
Peter&Christine Achey
White CopyJ�nspector's Fiie 4720 Bayside Rd
Canary Copy/S�te Notice Maple Plain, MN 55359
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 BUILDING CODE REQUIREMENTS.
---,. �
��, / ^ ,/
.
�" � �,�/G���,�� ' ` �, �,�'►/l
� ` PI.[CANT PERMITEE SIGNA"fURE ISS JED AY SIGNATURE
Copics: 1-File(Signatur•es Reyuired�, 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
, , ����� � �
�
,$ 1 ,
Total Fee: $ oZ�1•O 1 Date Received:�?,,.����_
Entered By: Permit#: �//,2�58'T
CITY OF ORONO - BUILDING PERMIT 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: ��c�U �_��� � Zjp; ��
O ►^ �.-�v
Will this b a P rade of Homes, Remodelers Showcase�ome or other Display Home?
❑ Yes _O If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
suff cieni on-site pai•king is available. Non permitted events will not be allowed.
NAME OF OWNER: �� � �.1Z C7 L�'l.� � PHONE: (home) ��Z_c�7�-5'6 l,tS'
(work) (o� Z - �`'3��i � � �y`�
MAILING ADDRESS: �7 �.v j�� ��5;��e � CITY: ()�O1 i� ZIP: 3S
j-t,�}C- �tSZ-�(72-5�'70
CONTRACTOR: J I,v v��/}L(-���<<��L��J.i l n PHONE: _��p/ Z-S��J� Z(ci J
CONTACTPERSON: �j�rr/j„/ ��js��^� MOBILE/PAGER: �c„-� C
MAILING ADDRESS: �v�, ,g,�� � �T- CITY: /�o�:�� ZIP: S� 3� �
STATE LICENSE: # ���Z�v EXPIRATION DATE: /�?c�rc � U<<'
ARCffiTECT/ENGINEER: � PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: �'�� � REGISTRATION: #
TYPE OF WORK: New Home Addition � Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detai�: � I ` z � ���
' %/` ' c'�r i� �cX�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��QD �
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: �/'�2���,_- DATE: 7- Z�-o �
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. L Type of data. The righu 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 bc given individual. An individual asked[o supply private or confidential data conceming himselfshall be
informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whe[her he may refuse or is legally required to s�pply 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 reauired under this subdivision in the individual income tax or r�operry 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 infortned 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 ofthe private or public data upon request by the individual subject ofthe data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,a�d compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuan[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 disagrecment. The
responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify pas[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 ac[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 ar 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 Statc Zip Phone
1 understand my rights as stated above.
Signaturc
Reset Form 32
qnv✓
�CKEC�K pFF i,IST FOR ISSUANCE OF ����TS
POR OFFICE USE ONLY�S ,��
A.DDRESS OR LE�AL: r�I��a �A --t -
PID: �
77�ES CRIP'I7��N OF W ORK.: cr� t�' d� (r►c.� �
-----------
-----------------------------
______----- ---------______�____ pATE APPROVED: � � G . �
ZOYING REVIE'4V BY: DATE APPROVED: � -A-G� . v
. � �
�U]ZDING REVIE�V BY: . � � w
� ------------------------- �
---------- �r �
` yc Misc. Fezs Calculated By: �
�EES TO BE CHA.R.GEA: Yes � No � �
PERNIIT SE�VER C�i�INECTION � �
PLAN ��E`V , Yes ✓ No .
No tiVA'I`ERCONNECTION � �
STATE SURCHAR.GE Yes v No �,A�{ gEE
INVESTIGATION FEE Yes � �
SAC Yes No STTEINSPECTION �
_OTHER (specify) .
Number of SAC�Units __________________________ �
- --�--
--------------------------
------------------------- �
�,pYT��ICr C�CK. L�S�' Zaaing Districc: • �
' Post Office: School District: � � �
Fire Department: . �
Lac Area: Sq.ft. `���A`cres Widch Depth �
- / �o Date af Survey: � � � Q
Survey Submitted: Z'�s __1�_ N
. . �' v
PropoSed Setbacks: �F�" .�t� ' : �
Front(�; �l fa► �Side: . �
� � � � �
Rear (��l;l�•Z ��Side: CJ ��
, � �
�Pn� rn�r���r C n�j �vPt�2T1�: �.�' � �
�'��3...,.._ S.. �--��-� - � �
�
auildin�Hei�iit: DeE< I-�gt. �/I A Peal`h��� V
Lot Covera�e: N �l�
Counc� A coval Dace: '
GradLn�: Staff App:oval Date: Pl?a. BY� pp
Szp�ic: ScafE Approv� D2te: � �� �� �� �y� W�
�o�� F��. � Resolutioa: „_________. R?solutioa Da'e:
Shorzlznd Distric�: h� �O�Coverz�e:
AvQ. Setbac'�_: BI�F:SetSack:
� Propased
�„LiSti[!o
H�ecover: G-7�'
7�-2�0'
Z�J-����'
���Q-i C�''�'
j..1a�CL,�'.:z. y'��,-:�,�2 ��:;C'.:2��: :2� ��� ,�_._ 0: �v'--'- •,`�- . ��.
-c��L''�:-�ti �Ln h0t��):
l.
SUILDING REVIEtiV CHECK LIST
UBC: 2- 3 � CONSTRUCTION TYPE: vN
Sq Faotaoe $ Per Sq Ftg
Basement . ,. X = .
lst Floor ' . x . _ '
2nd Floor x _ ' .
Garage X = .
z =
TOTAL
Estimated Construction Vaiue: $_ �j��o°
Inspections Required: `Yo�k Requiring Separate Permits:
5 i[e Plumbing Fire
� Hardcover Removal Mechanical Water Coaaec[ioa
�(' Footing ` Septic 5ewer Coanectio❑
� � Framing � Fireplace Lawn Irrigation
Iasuiati�a (Niasoary) Other
�Vall Board (Mfg.) Well (State Peraiit)
_�F�� Gradiog/Fillin� Eleccrical (State PeRni�)
O[her
RENIARKS (IlV HOUSE): '
--------------------------
REVLE'FV $X OTHERS: DATJE:
Access: Existing New �
Access Approval: Datz gy;
--------------
RE1�IARKS (TO EE NOTED ON T�FR��I?'I`};
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Established in 1962 INVOICE N0. 76558 �
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LOT SURVEYS COMPANY, INC. F.B.No. 1035-41 �
LAND SURVEYORS SCALE: � �� = 40' �,
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REGISTERED UNDER THE LAWS OF STATE OF MINNESOTA p �enotes �ron Monurnent �
7601 73rd Avenue North 763-560-3093 �
Minneapolis, Minnesota 55428 Fax No. 560-3522 �
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� Property Address:
� 4720 Bayside Road
`" � Orono, MN
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� Cr � Utility and Droinage � �O Pianning&Zoning Plan Review
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l MOST WESTERL Y ❑DENIED
%%CORNER OF LOT 1____ S 8 °32' 46" E Staff: ���
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Area of building is 1672 sq.ft ; Z
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Area of drive is 2136 sq.ft __5 — "'
58.4 cD ro deck area �? �� o Z�
Area of walk & stoop is 326 sq.ft 5 22 0,,,, `" �� o '�"
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Total hardcover = 4134 sq.ft. � � `° 2-s 8rm,� � � �z
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Area of proerty not including C? o N 22.2 N 23.3 �24 75N 45.6 � �o
roa d rig h t o f way = 5 4 3 0 2 sq.f t. � o �o , �on� � �~
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180.01
/ S 89°32' 43" E
�SOUTH L l NE OF SEC T l ON 31, TOWNSH lP 1 18, RANGE 23
The East 180.00 feet of the South 275.00 feet of the West Half of the Southwest Quarter
of the Southwest Quarter of Section 31, Township 118, Range 23. Also that part of Lot 2,
Block 1, Bayside Hill, Hennepin County, Minnesota, according to the recorded plat thereof
beginning at the most westerly corner of said Lot 1; thence North 16 degrees 16 minutes
05 seconds East, assumed bearing, along the most northwesterly line of said Lot 134.00
feet; thence South 78 degrees 30 minutes 05 seconds East 75.08 feet; thence South 05
degrees 32 minutes 43 seconds West 115.00 feet to a boundary line of said Lot; thence
North 89 degrees 32 minutes 43 seconds West along said Lot line 100.00 feet to the point
of beginning and there terminating. /'
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The only easements shown are from plats of record or information �'"� ,� �
provided by client. �
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We hereby certify that this is a true and correct representation of ��:;
a survey of the boundaries of the above described land and the ���, ��� ,n..•�..
location of all buildings and visible encroachments, if any, from or on Signed
said lond. Charles F. Anderson, Minn. Reg. No.21753 or
Surveyed by us this 25th day of July 2� �7 revised 8-2-07 prop deck Gregory R. Prasch, Minn Reg No. 24992
� a -p TIME �
CITY OF ORONO CALLED IN
INSPECTION N�I SCHEDULED D :�D
PERMIT NO. COMPLETED
ADDRESS 7 7�� �
OWN ER CONTR.� �-�1�
TELEPHONE N0. �P` o�- s�� a�� 1
� DESCRIPTION �I h�`'� ���'_�ii��
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z/0�4�WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q(` 0/5/FINAL 14 SEWER HOOK-UP 06 PROGRESS
�'Q7 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
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GW WORK SATISFACTORY:PROCEED � PROJECT COMPLETE ✓
W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECT�ON TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETl1RN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance. (J52� 249-4600
OwnerlContr ct o
Inspector.
White Copyllnspector's File Canary CopylSite Notice
PERMIT
CITY OF ORONO
2�50 Kel�ley Parkway- PO Box 66 Permit Number: p11211
Crystal Bay, Minnesota 55323 Permlt Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 7/11/2007
SITE ADDRESS: 4720 Bayside Rd Unit#
Maple Plain,MN 55359
PID: 31-118-23-33-0015
DESCRIPTION:
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Petmit Fee: $ 111.25 Valuation: $ 4,400.00
Plan Review Fee:
State Surcharge Fee: $ 2.20
TOTAL FEE: $ 113.45
APPLICANT: Two Teacher Construction OWNER: Peter&Christine Achey
2586 Aron Dr 4720 Bayside Rd
Mound,MN 55364 Maple Plain, MN 55359
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 BUILDING CODE REQUIREMENTS. �
�
�
APPLICANT PERMITEG SIGNATURE ISSUED BY SIGNATURG
Copies: 1-File(Signatures Required), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�
� PERMIT
CITY OF ORONO
2750 Keiley Parkway- PO Box 66 Permit Number: P11211
Crystal Bay, Minnesota 55323 Pel'I711t Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
7/11/2007
SITE ADDRESS: 4720 Bayside Rd Unit#
Maple Plain,MN 55359
PID: 31-118-23-33-0015
DESCRIPTION:
Proposed Use: Residential Census Code O/S-Building
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair
Permit Type: P
DETAILS:
Approved per resolution#:
Separate permits rcquircd:
NOTICES/REMARKS:
FEE SUMMARY: Perniit Fee: $ 111.25 valuation: $ 4,400.00
Plan Review Fee:
State Surcharge Fee: $ 2,2p
TOTAL FEE: $ 113.45
APPLICANT: Two Teacher Construction OWNER: Peter&Christine Achey
2586 Aron Dr 4720 Bayside Rd
Mound,MN 55364 Maple Plain,MN 55359
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 BUILDING CODE REQUIREMENTS.
.i _
., �_
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ICANT ERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(�f Septic, 1-Septic) Page 1
�
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT 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
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JOB SITE ADDRESS: �I��--v �J�G� �j Si�f' �l( I ZIP: S S 3S C�
Will this be a Pa -�de of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �O If yes, a special event permit is reguired with Police Department and Cily Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufftcient on-site parking is available. Non-permitted events will not be allowed
NAME OF OWNER: !{�, �' L � � � PHONE: (home) 7 S 7 � `J�,� �3 6 U�
Q � �`� (work) (�,� Z '�i�'-1 -l��i c,
MAILING ADDRESS: �(7�-u � f3�,�/��✓� ��CITY: Q✓�d�1C� ZIP:
CONTRACTOR � ) (,��'� �'�C���IC �U✓��� ��� ��1�-"` 1 ��PHONE: �'J`�Z - �/)� -�(� 7G
CONTACT PERSON: S;� �-r/�,� n.,�1�54 �� MOBILE/PAGER G, �7 -�y�-Z l� /
MAILING ADDRESS: _�5 b,� ,�,�� 1 �� CITY: M���� ZIP: ���i
STATE LICENSE: # ti�v�' 7��� EXPIRATION DATE: 3 U v�
ARCHITECTPENGINEER: � PHONE:
MAILING ADDRESS: `�� CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may re ire MCWD review and pe mits!
PROPOSED WORK(describe in detai�: —����- ���� --} �� 2v� j— �� �
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED . DETACHED
/� G'�
ESTIMATED CONSTRUCTION VALUATION(excluding land): �`I�v�
;'
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the wark will be in confarmance 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 pennit;and that the work will be
in accardance with the approved plan. ,
j�� .._ � �'� r �
APPLICANT'S SIGNATURE: � ������ DATE: � ��� �
31
�
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. l. 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 conceming himself shal I 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 shal I
not apply when an individual is asked to supply investigative data,pursuant to section ]3.82,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 propertv 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 dassified 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 ofthat data. After an individual has been shown[he 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 ofthe private or public data upon request by the individual subject ofthe 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 ofthc request,exduding 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
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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 Yhat 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[o the provisions of the administrative procedure act relating[o
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.
��`� %�^, /�1 G�r.�S � `�
First Middlc Last
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Address
/ v`���\ �� S. J ���1
City State 'Lip Phone
I understand y ri hts as stated above.
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Re�setForm ;r.���n`� 32
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DA TIME �
CITY OF ORONO CALLED IN ���
INSPECTION N IC SCHEDULED �7�r7"��
PERMIT N0. ����� COMPLETED
ADDRESS �720 v�-
OWNER CONTR. �L��O
TELEPHONE NO. Z -S9 � a/g/
� DESCRIPTION r"��
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 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-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR W4LL RETURN
�7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION RE�UIRED.CALLTOARRANGE ACCESS.
Call for the xt inspection 24 hours in advance. (J52� Z49-4600
OwnerlContr r site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
✓
DATE/^ TIME
CITY OF ORONO CALLED IN � � u ' •�� �
INSPECTION N SCHEDULED � •�
PERMIT NO. � � COMPLETED
ADDRESS ��� ,�
OWNER CONTR.�(11O �I P ��
TELEPHONE NO. CI�I Z 'S"[[�—ZL � '
� DESCRIPTION � '
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 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-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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:
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� ❑CORRECT WORK&PROCEED L, ISSUE CERTIFICATE OF OCCUPANCY
W
O Ci CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. Ci PHOTOTAKEN
INSPECTOR WILL RETUFN
=� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for ihe n xt inspection 24 hours in advance. (952� 249-46��
OwnerlCo ite:
Inspector.
White Copyll�spector File Canary CopylSite Notice
� PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P12o14
Crystal Bay, Minnesota 55323 Permit Type:
Mechanical Pernuts
(952) 249-4600 Date Issued:
5/1/2008
SITE ADDRESS: 4720 Bayside Rd Unit#
Maple Plain,MN 55359
PID: 31-118-23-33-0015
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Air Conditioning
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Install fan coil system and heat pump
FEE SUMMARY: Pernut Fee: $ 200.00 valuation: $ 16,000.00
State Surcharge Fee: $ 8.00
TOTAL FEE: $ 208.00
APPLICANT: Countryside Heating&Cooling OWNER: Peter&Christine Achey
6511 Hwy 12 4720 Bayside Rd
Maple Plain,MN 55359 Maple Plain,MN 55359
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 BUILDING CODE REQUIREMENTS.
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APPLICAN. P� MITEE SIGNATURE [SSUED BY SIGNATURG
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Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
� �
-- -- --__ .�_._. __ I
, roii c i rv usE ONLX ,
�0� City of Orouo `
P.O.I3ox G6 Date Recerved: 1'ermit N (
_ ,
0"r � 2750 Kellcy Park�vay i
�+*t`� Approved C3y Arnow�t'I� '
�`�i ,,�i � Crystal l3av.MN 55323 -- -
�'������''�a` (952)249-4600 -- ----_- -- -___. _.__.__. _ ___ .i
t,����4
CITY OF ORONO —MECHANICAL PERM1'I'
(All Commercial pennits must be approved by the Building Ofticiai or hispector and/or Fire Marshall)
--- - ---- _ - — ,
GENERAL INFORMATION -- __ __ ---- _ _ _I
1. You may apply for mecl�anical pern�its by mail or in person a[the City ofticcs, Applic�i�i��n:; will
be reviewed and a pernut will be issued within two working days.
2. Peritut cards will be sent by rehirn mail after a review is completed. PEKMITS ARP;N(�'i
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST N01' I3F.GIN UN'TIT., t'1;11�;
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechauical Desi�ns—Complete calculations, details and speciticaCious are rrc{uired tiir�-.�3<;h
heating, ventilation,hurnidification-dehunvdification, and air conditioning i��istallatioti uiciuding
heat loss/heat gain calculation, design temperahu�es, equipment ratin�;s an�l i�icntilicatiorr ,s�; tu
type,manufachirer and model. Data shall be presented on form providccl.
4. When any new construction or remodeling is involved, a separate buildini;peru�iil niusi `��r
obtained.
5. All work must be done in accordance witl�the Uniform Mechanical C'cxle/Stat.e Buildiu..>,t'ode
requirements. �
6. All work nnist be inspected(rough-in and fival). Call(952) 249-�4600.
(24-48 hour notice reyuired)
7. House Heating Test Record nuist be subnutted betbre fuial.
- ---.__ -—...__ ___--__ _
TYPE OF PERMIT �
� Check All That A 1
� PP Y)------__ -- _ I
�Residential ❑ Corrunercial (Approval Required)
❑ New ❑Additional ❑ Repairs �,�j iZeplace
�
Job Site/ Owner Information: .
Site Address: L� ��`� �� �,�S • �L ✓�� �
Owner: /� C h ey , �e.f e r Mailing Address: _%7a-d.---�°i�`�--R"�
�35�
c►ty: �rv�'� Zip� ---5___-_ _ - __._
Home Phone: y5d` �� �d 3��S Alternate Phone: _ ___
Contractor Infonnation:
Contractor: L��1+^�"`s•`�`" }I fG-�``�l�".� Co�ltact Person: �G"''�� ��, /%'^
Address: 6��� /��-1 JO� _ State Bond #:
City: �4�/� ��Q.:� Zip:�sjf`� Expiration Datc: _._ ___. _ _---- _.. __--___
Phone: ��i - �/�`� - /�� Alternate Phone: __ _____
❑ Insurance — Ctu�rent: _
___._ _ _.
1
. �� .
MECHANICAL SYST,EMS BEING INSTALLED
NEATING SYSTEMS
Quantity: �
Make:
Model: � —
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �t(�"�� ! �G�1 �
Make: ����t�i�- �f yo-n r
Model: aqG A�vA�3� `F`//�/✓�dOS
Tons: � 3U J y�
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
F'UEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ [nside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
� , �
> �
� '
�� ` � '� ���PERMIT FEE CALCULATION(S) �� ' � � �����
; � ,, = �_ .���. ��
' ' � � BASED OFF - 2002 STATE STATUE
,
��-�. � ��,��� � �
� Yes,this section applies
The replacement of a Residential fixture or appliance that nieets all three of the following reyuireir�c,nts:
1. Does not require modification to electrical or gas service.
2. Has a total cosY of$500.00 or less;exclt�ding the cost of Uie tixture ar appliance: ar�c°•
3. Is improved, installed or replaced by tlie ttomeowner or licensed contrac;i.o��.
Skip uext section, if this applies; Cost of Perinit �___ a`' ����
State Surcharge `� __ _ •���
Mail-Li Fee(It A�plicable) $ __ ._ '_`���
Total Per►nit I'ee �,__
'PERMIT FE� CALCULATION(S) ,-JOBS OUER$500.00 __ _ �
,
If above does not apply; follow guidelines below:
]. CONTRACT PRICE * is 1.25%of conhact price with a(n�linimu►n Fee af$35.0�
� �
�dc o�
__. __ __._
/�, x .oi2s � _ __ _ - -
(contrac[pricc) (minirnurn a�t;Ilf)1
2. STATE SURCHARGE ** Add the State Bldg Code Div. Si�rcharge(A�inimu��i�'re uf 5��50)
J� � /
� �� x .00OS $ � _---
(conlract price) -- (minin'iun�`'t; `;11 j
3. POSTAGF,&I�ANDLING(Only on Mail-In Applications) `h � -`���
�
4. TOTAL PERMI'T FEE(Add Lines 1-3 Above) g____ __�� �----------
■ * CONTRAC"T PRICE or JOB COST means the actual or estimated dollar amount char�;ec1 i�or the
permitted work iuch�ding materials, labor,profit, and other fixe�d costs. It is the amount to b�� ciiar�;etl
to the customer for the work done. If any material, equipment, labor or installations a�c ('i�rnished by
the owner, tenant or any other party, the reasonable market value of such items nnisl:t�c �itded to llic
estiinated cost or contract price for permit fee pluposes. in the r,vcnt thal. thcre is ��+ rlis4�tite on tl�e
flRii3l11'ii Of ti1C JOb COSi, ti10 Clt� I�i3y T0C(U85t t�10 SLI�J11llSS1C1: ^F�l S1d�1e-� :�`-�1�>3 `?f ��lF' :?':'�i'.-t� C�7't!C�iC!:.
■ ** 'Tl�e STATE SURCHARGE is .0005 of the Building Departmcnt at(952)249-4600 tor t�,�;��ricc.
--- --- ---- --- . _
,
�- MECHANICAL PERIVIIT APPLICATION AGR�EMENT__ ;
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agre�•�, to do all
work in strict accordance �vith the ordinances of the City ane3 thc re�;ulations of I(�t: St:atc c>f�
Minnesota, and certifies that all stateme�lts made on this �pplicatioa�� are con�pls��r, ic�.ie ar��_i
correct.
Ap�licant's Signature: L�`���`'�
��! O�
3
/
�� ��q� TIME t /
CALLEDIN V
CITY OF ORONO Jii _--� ��;�;
INSPECTION NO CE SCHEDULED
PERMIT NO. �0� COMPLETED PO43OO
� ,/����Q��� �� Septic
ADDRESS ��� °� ' 9/5/2001
OWNER CONTR. ��� -��
TELEPHONE N0. ' 7b3 7" 7 ��'Q
� DESCRIPTION � ' `�� �� � �/��
W ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FI�LING
� ❑ FRAMING ❑ MECHANICAL FINA� ❑ LAKESHORE/WETLANDS
�
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
� ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Z
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� 0 DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
W ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
_ ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Sub-type(s): New Septic System
J
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
�
�
�
O
�
�
O
�
W —
�
Q
�
Z
W
�
W
�
j
� ❑WORKSATISFACTORY:PROCEED �[,PROJECTCOMPLETE ✓
❑CORRECT WORK&PROCEED ,❑ ISSUE CERTIFICATE OF OCCUPANCY uation: $ 0.00
W TEMPORARY
O ❑CORRECT WORK,CALL FOR REINSPECTION
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
� �1 r! � �ris Achey
Inspector. �
'20 Bayside Rd
White Copyllnspector's File
Canary CopylSite Notice aple Plain MN 55359
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEIVIENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
„ �
, _ i
i f ,�
�-,.�"r - �� /r ,������� t�l �7t�=�Z /t'���
- APP A P ITEE GNATURE ISSUEDBYSIGNATURE
`
Cooies: 1-File(SiQnitures Required), 1-Aoplicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
,
CTTY OF ORONO SEPTIC SYSTEM PERNIIT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay, Mn 55323
JOB SI'TE ADDRESS oC ,j ir ��-F/�
Occupancy Type: Residential % Commercial Other
Permit Type: New or Replacement System $100.00 \�
Repair Existing System $ 50.00
(Tanks or Drainfield)
50.50 State surcharge added to above fees
* See fee schedule for non-residential permit fees
Owner's Name: � , � i Phone Number: S�—�17a-��(��15�
Mailing Address: t-- � % Z City: � ' 'n �'S�.S�
Contractor's Name: i Phone Number: �5� - �- 5`�s�S�
Maiting Address: C�� �,j�F.-E��,/� �>� City: '� ��K� Zip: 5 5"��/y
*** 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 Minnesota.Pollution Control
Agency(MPCA) 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
�uring pressure distribution piping installation in the rock bed.
D: Final inspection to verify proper final cover depths and to verify that all pump stations
(where required) components are functional and comply with codes.
5. Individual holding MPCA Installers License shall be present during all inspections. A 24-hour
notice is required for all inspections.
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate
boxes.
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 Capacities: 1) 1���� gal. 2) �oU�j 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 insta.11er electrician other.
C. Treatment System:
Trenches: s.f. X Mound
Depth of rock below pipe " Rock bed dimensionsl U ' x �O '
Drop Boxes Sand bed di.mensions `-}1 ' 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 ordinances of the City and the regulations of the State
of Minnesota,and certifies that all statements made on this applica � n aze complete,true and correct.
/ / ��.5�-��
SignatureofApplicant<� Date:
' � G
MPCA License No. �/ �
Staff Review: Approval � Denial
� -S- C>
Reviewer: "�'1� �-ci-,� Date• ,
Reason for Denial:
� 5<'e. lo�(�-�:o�; L> �1 �l' 4 �` ��`��\
SEPTIC SYSTEM APPROVAL
� � t � O ORON
0 C�P�
� �
0 0
CITY of ORONO
,� ,a�:�r,��,. �.
l5� Municipal Offices
� "" ti
�.t� ¢.�G Street Address: Mailing Add�ess:
�C'EggO 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner �hr�S Ac�ey Phone (Home)`�Sa-4�d-36oS(Work)
Address �i�ao (3avs�d� Qd CityMGple Plq;r. State t�ni Zip 55359
�
Site Evaluator 5�,e�1��� State License # 3q $ Phone# yya- 5$5S
Type of Establishment: Single Family �C Multi Family
Commercial Garbage Disposal Yes�_ No
No. Potential Bedrooms �-► Est. Gallons Per Day 6o U
Water Meter Required: Yes_ No x Soil Sizing Factor . � 3
Perc Rates P-1 a O P-2 a3 P-3 a o P-4 a 7 P-5 P-6 P-7
Restricting Layer Depth B-1 IS " B-2 I6" B-3 �5 " B-4 ►6`� B-5 B-6
Type of Treatment System:
Standard X Experimental Alternative
Pressurized Mound System X At-Grade System
Gravity Trenches System Pressurized Trench System
Gravity Trenches W/ Lift Pressurized Bed System
Holding Tank W/ Alarm
Septic Tank Size l000 , ►o�� # of Tanks a Lift Z'ank Size IOoo
Pump Brand GPM 3 �f Head 16
Treatment System:
Minimum �v x S�, (4l x >5� Square Feet with 9 inches of rock below pipe
Type of covering Fabric�_ Other
TffiS IS NOT A PERMIT. This is a design approval form which must accompany the site plan.
A permit must be issued to a licensed septic contractor prior to installation.
NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the
inspector (952-249-4600) Call for inspection 24 hours in advance.
ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and
fencing must remain in place until final site grading. Approval to pour footings will not be granted
until the lnspections Department has verified the primary and alternate sites are protected.
NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20' of tested drainfield sites ever.
ACCEPTED X DENIED By the City of Orono subject to existing regulations and
thefollowingconditions: PuM d- crv e ;St � fiq�KS, �o not ��- S�M P�m(�
wq`t�� `��o ne�- �o���, VQf�q�� G�a�'re 4or wc5-r s',deyq� Setback o� io �eet.
By: �,� �- s-o �
Matt Bolterman, On-Site Systems Manager Date
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
. . ' RECEIVED S we d 1 u n d
.
� JUL 2 2001 .
�ITY OF ORONO �� "��
p
Service
����
� ���
[�Perc Test
[�Soil Boring
["Design
❑ Installation Estimate
Prepared For:
L�/5��.S /�� �!�' y
,.
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I�'!AP �E' /�LA►'�1 -�'53.��'9
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Site Address:
_S'A n� E
(
� S�a�� Cerfifiec�
�
i
� Swedlund Septic Service • 9520 Laketown Road • Chaska, MN 55318 • 442-5855
: ; �,vNo
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�
�
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SEPTIC SEPTIC SYSTEM DESI �����
Date �v�2Z—o /
Owner/Builder ��`�'�iS �Gl1 E �/
Address �7Z O •�6�-�Si�� �0,9 �
Site Address J`^�i1m E.
Home Phone 9�'S�2� 3�os Work Phone 1cS�Z-7�?-77 7� Pager/Cell
The fol/owing information has been compiled for a single family home:
Bedrooms_� GPD <oo d Garbage Disposal iV o Lift Pump in Basement N O
Septic Tank Capacity Zoa o Pump Tank Capacity /D o O
System Type: Mound �_ Trench
Distribution: Gravity Pressure �_ Land Slope ��/b
Depth to Restricted Layer /S�� Soil Sizing Factor . 0 3 Perc Rate ��O�30 l�^'�
Trench System: Drainfield Size/Sq. Ft. Lineal Ft.
S62 Number of Laterals Rock (Tons)
Rock Width Max Trench Depth Width
i
Mound System: Rock Bed � X6� Sand Layer ��2 X '/�
,
Upslope /2,fz Downslope 1� Sideslope /Z �
� ii , ii
Sand Depth 7 - // Topsoil on Site �� Trucked in E�
Sand (Tons) Zz d Rock (Tons) z�� Topsoil (Tons) �40
Pump Manufacturer: A. y n'�C ��wA l� / C9� l d
Requirements: GPM �g Head �� �� l�
i .�
Force Main Length � Diameter Z
Number of Laterals 3 Length �/O �
Swedlund Services • 9520 Laketown Road • Chaska, MN 55318 • (612) 442-5855
STATE CERTIFIED
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r�r��.�;,a�� A� ,;U p1A�� �,-�' ,�E a�,,d� �! , ' ` �'� i
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�'g.,.£� �20�`FG�`�'+—l� Q.4¢.¢�E'�c> it r 1/6 7" �� « \' \ �
/�,�v�cJ �o A��ow Egac.�:�.raE,u� -r- �r�+�e,2,,� �s � /i�'''� s �L� (���/
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Z"-o�'��►•io ,L.�..e C'sv.uEe ��. d � Z.�+`t�'�s �eA,'w-�ra I a� � ���\ �� Z Z–o /
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' , MOUND DESIGN WORKSHEET 5
�
' ' (For Flows up to 1200 gpd)
A. FLOW Estimatcd Sewagc Flows in Gallons per day
Estimated .�O�gpd Number Type 1 Type II) Type ID Typz
or measured x 1.5 = gpd. °` `v
�
2 sao zzs iso �,
B. SEPTIC TANK LIQUID VOLUMES a o 330s° zs� °f�
����
�000 gallons 6 '9050o su s�z T,,'a,.
7 1050 600 370 p m
8 1200 675 408 �
C. SOILS (refer to site evaluation) `°'"�"ss
, �.
1. Depth to restricting layer = 1�inches /�+� � ���Tank Ca .a���;� w�
feet Liquid capaciry
2. Depth of percolation tests = /Z inches "°^����� Minimumliyuid Lyuid�aorywi�h �w�,��,&
Bednx�mc Capaciry garDagc d�spvsal lih iosidc
2�x Iccs 750 1125 1500
3. Texture Percolationrate 0�3o mpi �„<< �� ,� 2�
5 ur e IS00 2250 3000
4. Land slope���0 7.R��r Y 2000 3000 4000
D. ROCK LAYER DIMENSIONS
1. Multiply flow rate by 0.83 to obtain required area of rock layer: A x 0.83 =
oc� gpd x 0.83 sq. ft./gpd = �odsq. ft.
2. Select width of rock layer (max 10' if<120 mpi max 5') = I b ft.
3. Length of rock layer = area_width = , , < a��n�� sa�o ��.�a eo=e� Qo
9 _o�=o o^o ab..
Jrbo sq. ft. . �-ft. _ �o ft. -0-:�°°D,��D a ec,�o¢ p .
4Q'oq op,Aa"n.o oeapqoo . . .
� a oo po poa���aD p=. .
Width �ft a�pDpOD D oD e
<120mpi <10' Length �'a ft
E. ROCK VOLUME
>120mpi <5'
1. Multiply rock area by rock depth to get cubic feet of rock;S'� sq. ft. x_�
ft. =S�v cu. ft.
2. Divide cu. ft.by 27 cu. ft./cu. yd. to get cubic yards;
�� cu. ft. =27= 78 cu. yd.
3. Multiply cubic yards by 1.4 to get weight of rock in tons; Zo cu. yd. x 1.4
ton/cu. yd. _?�_tons.
F. ABSORPT'ION WIDTH �` Absorption Width Sizing Table
1. Percolation rate in top 12 inches of soil is �n mpi ��,��,�;� Gallons �o�A��
Texture �0'�� Minutts per Inch Soil Tezture per day per width to Rock
(MPI) square foot Layer wdth
Fasmr Nan 0.1 Coaru Sand 1.20 1.00
0.1 to 5 Smd 1.20 1.00
2. Select allowable soil loading rate from table; o.<<o s Fne Sand o.6o Z.00
6 to]5 Sandy Loam 0.79 1.52
,�� �pd/� 16 to 30 Loam 0. 0
at' o t t oam 0.50 2.40
46 to 60 Clay L.oam 0.45 2.67
60 to 120 Clay 0.24 5.00
3. Calculate adsorption width ratio by dividing rock layer s�o,��,��zo c�aY o.zo 6.00
loading rate of 1.20 gpd/ft2 by allowable soil loading rate;
1.20 gpd/ftz= ,6o gpd/ft2 = 2�00 .
4. Multiply adsorption width ratio by rock layer width to get
required adsorption width;
Z x /o ft =�o ft
' � DOWNSLOPE DIKE WIDTH
i. If landslope is 3%'0 or more, subtract rock layer width from
adsorption width to obtain minimum downslope dike toe
�o ft-�ft =1�feet
2 Calculate Minimum mound size based on geometery:
a. Determine depth of clean sand fill at upslope edge of rock
layer: Separation ��feet
b. Muldply rock layer width by landslope � rao� co�.�
1 foot Ro •E
to determine drop in elevation;
Slope Difference S�Der�tlen ���•.�
�x, •� %+ 100 = � feet SIoO• Ditt�neo• t
uo iop wia�n
c. Add de th of clean sand for se aration (2a) �Lr..�
P p Rock,e�a wia�n
at upslope edge,depth of rock layer(1 foot) to depth oE �L leet DowneloDt wial�
cover(1 foot) to find the mound height at the upslope edge �''•"
of rock layer;
i9
�� 7 ft+ lft + lft=3,� feet
d. Enter table with landslope and upslope dike ratio.
Select dike multiplier of �, �/�
e. Mulriply dike multiplier by upslope mound height
to find upslope dike width:3.7 x 3.dS= /2'/z feet
f. Add depth of clean sand for slope difference (2b) at
downslope edge, to the mound height at the upslope edge
of rock layer (2c) to find the d wnslope height;
3. � ft+�ft =�feet �4 1
g. Enter table with landslope and downslope dike ratio.
Select dike multiplier of y 7 L
h. Multiply dike multiplier by do lope mound he'ght
to get downslope dike width. , x �� _,�feet l�/.S'
i. Compare the values of step G.1 nd Step G.2h Select the
greater of the two values as the downslope dike width; ��
.S� feet
�o��op w�a��
j. Total mound width is the sum of ��••�
upslope dike (G.2e) width plus rock � ,�K ,M,,,�
16�
layer width (D.2) plus ya o �os�oo ��a�� "" �,.�,p w�„�
r��t i��i
downslope dike width(G.ti); ; �
� ,
/ '2 ft+�ft +�Sft = Zfeet��
k. Total mound length is the sum of 00 ""°°•W'°`" '
, ��..�
upslope dike width (G.2e) plus rock layer
len h(D.3) plus upslope dike width (G.2e); � ��•�
�ft+�5�ft + �ft = 7� feet
�. _ P'�
To�.��.�q��
owns ope ps ope
a:i �i s:� si r> >� �:i s:i s:> >:i e:�
x��
o ao �o s.o ao �.o �o �.o s.o �.o zo en
1 3D9 117 5.7b �3! 757 291 3.55 �.76 5.66 651 7.�1
2 �.19 �.35 556 6.fl2 6.1� 2.� 7.70 lSl 5.36 i11 6.90
3 330 l5/ 5.88 732 6.D6 2.75 J�� �.35 S.OB 5.79 6.15
{ 3A1 l76 675 7.l9 9.T1 26S 3.15 �.17 �.61 5.16 6l16
S 357 S.� 467 E57 10.77 261 ].17 �.00 . �.61 5.19 577
6 )E6 5.7b 7.1� 9JE 1207 2.51 ].Z7 3.55 �.�1 1.4J SAI
7 7d0 556 7.69 IOJ� 1J.7) 2.�b J.11 3.70 �1J �.70 5.13
! ]% 5.!! !3l 115� 15.91 2.Q 1Q! 357 �.QS �.�9 IA6
9 �.11 6.25 9.W 13.W 1e.92 2�6 294 3.15 3.90 {30 l65
10 l29 �67 10.0 15.00 � ZJJJ 2l1 2.86 737 3.75 �.12 �M
11 �M 7.11 ]l.11 17.45 70A7 226 27S )1] ].61 7.95 {]6
12 �b9 7.69 1250 21.13 U.)5 L2t 2.70 ).12 1.19 7.80 �.OE 64
� � PRESS RE D[STRI�UT�ION SYSTEM
1. Select number of perforated laterals
2. Select perforation spacing = � ft.
3. Since perforations should not be placed closer than 1 ft. to
the edge of the rock layer (see p. E-14), subtract 2 ft. from the
rock layer length.
Rockl��„g�, ' 2 ft. _ ��ft.
4. Determine the number of spaces between perforations.
Divide the length above by perforation spacing and round E-17a
down to nearest whole number.
TABC.E OFPERFORATION D[SCHARCES IN C('�'
Head Perforation diameter(inches)
Length perf. spacing =4� ft. � 3 ft. _ �spaces ��32 �!4
�3� �2� t.0a OS6 0.74
1.5 0.69 0.90
5. Number of perforations is equal to one plus the number of 2.ob o.so i.oa
2.5 0.89 1.17
perforation spaces . s.o o.9a �.za
4.0 1.13 ].47
I� spaces + 1 = / 7 p 5.0 1.26 1.6�
erforations/lateral aUse 1.0 foot of head for residentia!systems.
bUse 2.0 feet of head for other establishments
6. Multiply perforations per lateral by number of laterals to
get total number of perforations. E-17b
'� ►4um Jle.�el�meOu d s��a(a��a�Wad m �
x �- = s� erforations. ""�"�°`��"'°"�
laterals perfs/lacera! p "�Yj°'�°� 1.25 inch 1.5 inch 2.0 inch
2.5 14 18 28
7. DeterTnine required flow rate by multiplying 3.0 13 i� z�
3.3 12 16 ZS
number of perforations by flow per perforation a.o tt is z3
(see page E -17) s.o io ia z�
�/ X ,7 =3S gpm.
�5 sas��� E-�5
�,�.,�..��..�.�o.'.,.�,�.,.,.�.
-er
8. If laterals are connected to header pipe as shown on page E- �
15, select minimum required lateral diameter from table on �-,,:.Y�
page E-17; enter table with perforation spacing and number ,,,.-''' �L''
of perforations per lateral. Select minimum diameter for `/'�
perforated lateral = � inches.
E-12
�--�.�...^--�,�:�,�..�
9. If perforated latera: system is attached to manifold pipe near �,;,�_:_„ ,�,�
the center, a�; on page E-12, perforated lateral length and �"`�� -•�
number of perforations per lateral will be approximately one �''�"`�
.
...�,.��
half of that in step 8. Using these values, select minimum _� . ,,,,.
diameter for perforated lateral from page E-17 as �r'''� "-
inches.
� ` • 9
PUMP SELECTION PROCEDURE
A. Determine pump capacity:
Gravity Distribution
1. Minimum suggested is 20 gpm
2. Maximum suggested is 45 gpm Perfotation Discharges in GPM
Pressure Distibution Head Perforation diameter
feet inches
3.a. Select number of perforated laterals 7/32 �/4
b. Select perforation spacing= feet. 1.0a o.56 0.74
c. Subtract 2 ft. from the rock layer length. i.5 0.69 0.90
2.06 0.80 1.04
R«�irYe���g�n"2 ft. = feet.
d. Determine the number of spaces between perforations. a Use�.o foot single homes.
Length perf.spacing= ft.= ft. = spaces b Use 2.0 feet for anything else.
e. spaces+ 1 = perforations/lateral
f. Mulriply perforations per lateral by number of laterals to
get total number of perforations. �e a s x �r 5���= perforations.
$• T x�,m��a= gPm.
SELECTED PUMP CAPACIT'Y 3S gpm
B.Determine head requirements:
1. Elevation difference between pump and point of discharge.
�feet
2. If pumping to a pressure distribution system,five feet for pressure s���ad"�,�SYs�e"'
required at manifold if gravity system,zero. °�°="'°�
�.r.., feet row P��ie,Rm
3. Friction loss
a. Enter friction loss table with gpm and pipe diameter. t„�e .� ElevationDifference
Read friction ss in feet per 100 feet from table(F-14). P`�
------- -- -
F.L. _ � ft./100 ft of pipe
_....- ...... .
b. Determine total pipe length from pump to discharge ----------------"--------------'-�--'
point. Estimate by adding 25 percent to pipe length for fitting
loss, or use a fitting loss chazt(F-15 feet).
Equivalent pipe length- 1.25 times p p length=
.36- x 1.25=�.�feet Friction Loss in Plastic Pipe
c. Calculate total friction loss by multiplying - �
friction loss in ft/100 ft y equiva e t pipe length /! Nominal
Total friction loss-z��x�:100-�Z feet pipe dia.
Flow Rate
4. Total head required is the sum of elevation difference, �m 1.5" 2" 3"
special head requirements,and total friction loss.
�,,� � � � 20 2.47 0.73 0.11
�_+ +1•Z•S 25 3.73 1.11 0.16
(1) (2) (3c) 30 523 1.55 023
� 3� 6.96 2.06 0.30
TOTAL HEAD �feet �� 8•91 0.39
45 11.07 . 8 0.48
50 13.46 3.99 0.58
55 4.76 0.70
C. Pump selection bo 5.60 o.s2
65 6.48 0.95
70 7.44 1.09
1. A pump must be sele te o deliver at least
�gpm (Step A) with at least�,�"7_ feet of total head (Step B).
� , Sizing of Pum� Station
�
1. Detcrminc Surfacc Arca T
Rcctanglc=Arca= L x W W'��h
x = square feet 1
Lcngth
Circle= Area =n x(Radius)z
3.14 x x = squue feet Radius
Other=Get Surface Area from Manufacturer n=3.1a
square feet
2. Calculate Gallons Per inch
Thcre arc 7.5 gallons per cubic foot of volume,thcrcforc you must multiply the arca
times the conversion factor and divide by 12 inches per foot to calculate gallons per inch
Arca x 7.5 gpft 3+12 inchs per foot
x 7.5+12 =��$allons/inch �E�/� �'1�,'"�� �'�S
3. Calculate Gallons to Cover Pump(with 2 inches of watcr covcring pump) Estimata!Scwage Flows in Gallons per day
(Height(in)+2 inches) x gallons/inch(#2) �g��
(1�_+ z )x � _ �?2 gallons um r
of Type I Typc[I Typc III Typc
Iicdrooms 1 V
4. Calculate Total Pumpout Volume
a. To maximize um life select sum size for 4 to 5 um o rations r da 2 300 225 lA0
P P P P P P� P� Y• 3 aso 300 21s �
Ob ��+4= �6� �<9��OItS pC�C10SC' 4 600 375 256 �a�ucs
b. Calculate drainback 5 750 45U 294 ;,,
-- 6 900 525 332 Trr��.
1. Determine total pipe length,�S feet. 7 loso 600 370 ""`
2. Detcrmine liquid volume of pipe, /� gallons per 1(x)fctit. 8 1200 675 408 «,i��
3. Multiply length by valume: Drainback quantity=
�— feet x�gallons/]00 ft. __�gallons.
Pi diameta inchas Gallun.a r 100 fce�
c. Total pump out volume equals dose volume+drainback 1 4.4
��� eallons per dose+�o _gallons= ��� gallons 1.25 7.77
1.5 10.58
5. Calculate Volume for Alarm(typically 2 to 3 inches) 2 17.43
Depth(in)x gallons/inc (#2)= 2.5 24.87
� x 2.3 =�gallons 3 38.4
4 66.1
6. Calculate Reserve Capacity(75%the daily flow)
Daily flow(see page D-7)x.75=
�x.75=�gallons
Reservc Capacity
7. Calculate total gallons
gallons over pump+gallons pumpout+gallons alarm+gallons mserve capcity
ii3+�i4 c+#5+#6
�L Z +�+�[(�+�b =�gallons Alarm
Pump On
8. Totai Depth (Total gallon dividcd by gallon per inch)
Total Gal on (#7)+�allon �nch(#2) To I Pumpout Volumc
���+ 23 =�inches Pump OfF
Pump Hcight
9. F7oat Scparation Distancc(equal total pumpout volumc)
Total p�mpout volume�( 4c)+gallons/inch(#2)
�S_�o<� = inches
• � , LOGS OF SOIL BORINGS
Location or Project �z n ��9�-j 5,'c��
Borings made by SWEDLUND Date �-22-0 /
Classification System: ❑AASHO �USDA-SCS ❑ Unified ❑Other
Auger used (check two): 0 Hand ❑ or Power; ❑ Flight 0 or Bucket; ❑ Other
Depth, Boring Number � � Depth, Boring Number �Z
in feet Surface Elevation in feet Surface Elevation
o /n� � o o /I')��us E �/ /1� !Z
�/1Z �0-�9 n�v 2!2- ��O �crAi,v �i Z-
, - �Z� � ' - /o S�z � �.o-�wt `�1�l
zt/ S�l �,�q,,,� l� �o
2 — " " " ' 2 —
?y c l� �' �
3 — r_ 3 — /�1 D ) '�-E. d �� i/
�o�1�� ,�� �s
4 - �� �' 4 - �'�z
��� ��Z AT �-
5 — 5 —
6 — 6 —
7 — 7 —
8 — 8 —
9 — 9 —
10 — 10 —
End of boring at 2/ feet. End of boring at Z <L feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
l� Not present in boring hole. � Not present in boring hole.
r •
Mottled Soil: � ,,! Mottled Soil: � ,�
❑ Observed at�feet of depth. ❑ Observed at � �� feet of depth.
❑ Not present in boring hole. ❑ Not present in boring hole.
• r LOGS OF SOIL BORINGS
Location or Project y7z D ,C76�,,i S i�Fi
Borings made by SWEDLUND Date �o'ZZ —o �
Classification System: ❑AASHO C�1 USDA-SCS ❑ Unified ❑Other
Auger used (check two): L�1 Hand ❑ or Power; ❑ Flight C✓(or Bucket; ❑ Other
Depth, Boring Number 3 Depth, Boring Number � �
in feet Surface Elevation in feet Surface Elevation
p Uus / p t nJs� �/ /C9 2
��� ,C�d'4,�`.,. �Z ��z �,9.,�.� 2f Z
1 - l� � ,.L �v�-� �l� 1 �2 oS/.L �ati4x- `}��'
'�1 7 '�j
2 — 2 — �
3� � l /�// � .r
/�'10 �I �. c� l�'1 D�e. � /�
3 — 3 —
C��Z. ��� � ��ds ��2 �'2l,� �,���5
4 — 4 —
5 — 5 —
6 — 6 —
7 — 7 —
8 — 8 —
9 — 9 —
10 — 10 —
End of boring at z/z feet. End of boring at 2 /� feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
❑ Not present in boring hole. ❑ Not present in boring hole.
Mottled Soil: Mottled Soil:
❑ Observed at feet of depth. ❑ Observed at feet of depth.
❑ Not present in boring hole. ❑ Not present in boring hole.
, Dat� _�v-Zz-d / PERC TEST BY SWEDLUND SEPTIC
� Location _ G�7�o �A...,S f�� Hole # � Depth �2 ��
Soil Depth p - /Z, Texture �ora^-✓
Depth of Initial
Water Filling �o ��
Perc Test starting Time and Date: Time /.oo Date G-Z Z..^-o l
Time Intervals Drop in Inches Perc Rate
�- 2� .-.-,... ��� �p/'� i
:o qd �, y .
-• r., .
ya... z �► �� �
Date lo'2Z-o / PERC TEST BY SWEDLUND SEPTIC
Location ��1 M� Hole # Z Depth /2��
Soil Depth d —/Z Texture �w
Depth of Initial
Water Filling /o�
Perc Test starting Time and Date: Time %'r�o Date �-2 Zfb /
Time Intervals Drop in Inches Perc Rate
- /�`<' Zo +... � � �.�.n .�
�i yb .� � .
,
�. � �
''�-- � ,
Date �o�Z2-o / PERC TEST BY SWEDLUND SEPTIC
Location o�Ar+�� Hole # � Depth �2 ��
Soil Depth O-�'L Texture �e�4�
Depth of Initial
Water Filling �o ''
Perc Test starting Time and Date: Time /�oa Date G 2 L-o �
Time Intervals Drop in Inches Perc Rate
"' ,3 0 2 ..�- /S ��►'� �
.�_ '� ,� � o.+1 %
so 2 •� i� .
�.�. .
. Date ��Z2- o � PERC TEST BY SWEDLUND SEPTIC
` ' . /� ��
Location �7Z0 �1G�-j� � �� Hole # �" Depth �Z
Soil Depth O—/Z Texture ��sAiYl
Depth of Initial / ��
Water Filling �
Perc Test starting Time and Date: Time I•�b b Date �-1Z-o /
Time Intervals Drop in Inches Perc Rate
i o 3 o Zv .+.�--� 3 z ,
•+,. .
3� �o ,� j '
— 2 �91/��
�-O� Z .e r� 3 Z7 �+t %
Date PERC TEST BY SWEDLUND SEPTIC
Location Hole # Depth
Soil Depth Texture
Depth of Initial
Water Filling
Perc Test starting Time and Date: Time Date
Time Intervals Drop in Inches Perc Rate
Date PERC TEST BY SWEDLUND SEPTIC
Location Hole # Depth
Soil Depth Texture
Depth of Initial
Water Filling
Perc Test starting Time and Date: Time Date
Time Intervals Drop in Inches Perc Rate
� . RECEIVED Swedlund
JUL 2 2001 .
CITY OF ORONO S e t i c
p
S ervice
; �i1lS SYSTEM IS DESfGNED FOR
�BEDROQMS. ANY�NCREASE IN NUMBER
REA
' Perc Test QF BEDROOMS tNYAUDATES TH[S DESIGN,
[�Soil Boring
[�Design
❑ Installation Estimate
Prepared For: •
�',�/�;s % �y
��1a ,B�,�S;dE ,PAd
L2�P �E P,l A►'� -�'S3S9
d Z-- t�`J2• 3 G c�S
gs-z - �4/z- 7z �� o�-�.c
Site Address:
_S'A a►E
, :
>:
: ..S�:a��; :�e�-tifi'ec�
�
4
Swedlund Septic Service • 9520 Laketown Road • Chaska, MN 55318 • 442-5855
� , ��No ,
�,o
�
�
SEPTIC SEPTIC SYSTEM DESIGN
Date ��O-2Z—o /
Owner/Builder , �r`y.t�i S �G�C y �I
�lddres`� �7�:O •�6��S.iF�� � �
Site Address_ S�rn �
Home Phone ��'S�72� 3�os"— Work Phone 1c��7�1�75� Pager/Cell
The follo.wing information has been compiled for a single family home:
Bedrooms '� _ GPD �oo b Garbage Disposal N a Lift Pump in Basement N�
Septic Tank Capacity �oo o Pump Tank Capacity ��o O
System Type: Mound _�_ Trench �
Distribution: Gravity Pressure � Land Slope ���o
Depth to Restricted Layer /S�� Soil Sizing Factor . 0 3 Perc Rate ��'�30 1�4�*s
Trench System: Drainfield Size/Sq.Ft. Lineal Ft.
S62 Number of Laterals Rock (Tons)
Rock Width Max Trench Depth Width
i
Mound System: Rock Bed D X6-b Sand Layer �i�X 7/�
,
Upslope /2,�t Downslope 1�_ Sideslope /Z /2
� ii , ii
Sand Depth 7 - // Topsoil on Site �d Trucked in LS
Sand (Tons) Z Z n Rock (Tons) Z�� Topsoil (Tons) j4�
Pump Manufacturer: A. Y 1ti'1C �a�,A �d / C9ors l �
Requirements: 'j
GPM �$ Head
i .�
Force Main Length � Diameter Z
Number of Laterals 3 Length � �
Swedlund Services • 9520 Laketown Road • Chaska, MN 55318 • (612) 442-5855
STATE CERTIFIED
�
i i
�e\\ nov 9���
1 �
ti�
-�;�t�
w
.�l
� ,nf�;'y b�'� �
�� B PBz —'�'
CITY OF ORONO _,,_ a'� �no.���
SEPTIC PERMI P N REVIEW �N�- _
�.az� � Pd� (I I
INSPECTOR e �M I -
DATE �-�_�--0�--pERMIT NU�._..--- M I
APPROVEA AS Sti8'Kt'i"CED
3s��
� AFPROVED WITH CORRECTI0T3S AE� e /
NOT APPROVEU-CORRECT L AESUaI�[2 �w'
A8 w�e'k a1�sN�e�/ •
Thcse commcros are foT yo�n����� ��n8��. �
in full compliance Nit6 ali xppl�cab���noted ia thu raviow. �
Reyuirements including ftems not sptci
K6EP TH[S PLAN S6T Olv S[TE AT ALL TUN68 ��E�-S
� 6y,,
_ / ( Z i
�►10 J�- �.�..,� �c.�`�Aa� d � s�-,�.c S;-tG
4 • ����� '�'
�9s /,asT o�v ��i �/ (�ae�.�S � . f,,� �,z�s h �
�`'-�y.,. Q
, , � � � 4I
�fE 6 ,�e�+e�C t..s hicls a� � 2Fi„o��c�
A�io w ��.��s ��..y� yi9.�d- � � N�
�
�^� qT6� '/ ,� �/qaiS= a/:Ba�C.c� H'��iE.L � l � ' �s, --_..__....� �� �b� �
� � P wi � ) � �
/�1/�7�.z••a�S /9 2E /..� �1.1AtE C i� .ZE aPv�t t c� , 1 G
�� I��
r,,.�� ��<���5 Q,�¢d�.0 .►►.v6� d� ' �' � � �
,� ���
/�,VvscJ -T, A�/o�..� E�v;�..�E.v7' 9� i1,ar�Q2,N ls � �A�S/ ��/ ��/
'7�0 �!-r�. \ N" ( ,
� ��wP� �Y ��d,�,�a �48
/ /� l / � \ ��z-�n�a-�s�s
��bU....d t0 �E •�'EEdE� •Q`' �i�w�K+ir. �>2� �
c�
2"��'�P ,L,�..c �'�y.,Ee �� d � �X�c�•�S e�eA;w �al� � � �� za-o i
� `
�... ._. �, .,
' MOUND DESIGN WORKSHEET ' S
(For Flows up to 1200 gpd)
A. �OW + Fstimated Sewage Flows ia Cnllont per day
'� ^ d)
Estimated�O��;pd z � Number 'fype 1 Type II Type ID Type
or measured - x 1.5 =� gpd. °` `�
a� 2 3ao zzs tso �,K
B. SEPTIC TANK LIQUID VOLUMES � : a � 3� 2� ofa�
�000 gallons : . � � '� 6 9 0 °su � ��
� +¢^�` �� 7 1050 60� 3)0 Type 1.
�,,,. ,•� y° iK � � �� 8 1200 6�5 408 uj
C. SOILS (refer to site e�al n�� �� � ; "� .,� � „ °°'�°°�
' �� ��� ��
1. Depth to restricti�g r� '= inches /�3 feet ,;�,v,w„o,r
� �'711II�1C111( /�'�1IIIIGWDIII�YIO{J�t/Ci�fi�lyv�L �If7141fPOSi�Qf
2. Depth of percolat"�io t ts� inches �w� ��r �a�, �,��
2�*� �so i��s isoo
3. Texture Perc'�12t�on rate ��3 o mpi 3,x. �� ,� �
4. Land slope�/o �SR"�y 2� �° ,�°
D. ROCK LAYER DIMENSIONS
1. ' Multiply flow rate by 0.83 to obtain required area of rock layer: A x 0.83 =
oC� gpd x 0.83 sq. ft./gpd =cT'odsq. ft.
2. Select width of rock layer {max 10' if<120 mpi max 5') _ /b ft.
3. Length of rock layer = area_width = � Q e n e. Q o , ._.e, o e<e,,Q
4 0 o/�.a�.o> �o^�eo>e pll�.
Sbo sq. ft. . �_ft. _ �'0 1 L_ oQ:es,!Qa eD,0,d8D ooe�Qa
.QQOd°�o:QQ e.o:e re ea:a'o o p� _
0 0�Q��O'�DOU�DD qj,1:.
Width�ft Qoeoo�+ o�0'aO�D➢ 9 e) �
� <120mpi <10' Length �o � ft�
E. ROCK VOLUME >120mpi <5'
1. Multiply rock area by rock depth to get cubic feet of rock;S'� sq. ft. x�_
ft. =S�cu. ft.
2. Divide cu. ft.by 27 cu. ft./cu. yd. to get cubic yards;
�� cu. ft. =27= 28 cu. yd.
3. Multiply cubic yards by 1.4 to get weight of rock in tons; zo cu. yd. x 1.4
ton/cu. yd. =7�tons.
F. ABSORPTION WIDTH �� Absorption Width Siring Table
1. Percolation rate in top 12 inches of soil is �n mpi ��x„t� ��,� ,���,�;�
Texture ��'N' '�`� Miourcs per Inch Sal Teznue per day per w�i�h to Rock
(MPI) squacc fooc liyc�Yidth
Fasur Nan 0.1 Coarx Sand 110 1.00
0.t to 5 Saod 1.20 1.00
2. Select allowable soil loading rate from table; o.,�s Fine Sand o.�o z.00
, ^ ��/� 6 io 15 Sandy L,oam 0.79 1.52
.(/v 16 co 30 Loam
it SO 24p
46 ro 60 Clay[.oam 0.45 267
60 w 120 Clay 0.24 5.00
3. Calculate adsorption width ratio by dividing rock layer �'°"�*'��°�zo c,�y o�0 6.00
loading rate of 1.20 gpd/ft2 by allowable soil loading rate;
1.20 gpd/ftz= i(oo gpd/ftz= Z�oo .
4. Multiply adsorption width ratio by rock layer width to get
required adsorption width; •
Z x /o ft=�Qft 4
DOWNSLOPE DIKE WIDTH
i. If landslope is 3°l0 or more, subtract rock layer width from
adsorption width to obtain minimum downslope dike toe
� -�o ft-�ft =�_feet
2 Calculate Minimum mound size based on geometery:
a. Determine depth of clean sand fill at upslope edge of rock
layer: Separation ��feet
b. Multiply rock layer width by landslope � roo� co�..
to determine drop in elevation; � roo� Ro .a
Slope Difference s•v.�.��e� ��r..�
�X�%+ 100= � feet s�ev• o�tt�nne• t
uo iop wiain
c. Add depth of clean sand for sepazation (2a) ��••�
' aoek e o w�atn
at upslope edge, depth of rock layer(1 foot) to depth of �r..� Down�lo0�w10t�
cover(1 foot) to find the�mound height at the upslope edge ��"'�
of rock layer; �9
�• 7 ft + lft+ lft=3►� feet
d. Enter table with landslope and upslope dike ratio.
Select dike multiplier of �, S/-�
e. Mulriply dike multiplier by upslope mound height
to find upslope dike width:3.7 x 3.45'= /2'/r feet
f. Add depth of clean sand for slope difference (2b) at
downslope edge, to the mound height at the upslope edge
of rock layer (2c) to find the d wnslope height;
3. 7 ft+�ft=�feet �., 1
g. Enter table with landslope and downslope dike ratio.
Select dike multiplier of y 7 G '
h. Multiply dike multiplier by do lope mound he' ht
to get downslope dike width. . x ��7� =�feet I�.S'
i. Compaze the values of step G.1 nd Step G.2h Select the
greater of the two values as the downslope dike width; �
.S' feet
�o.�o➢ w�a��
j. Total mound width is the sum of !2��..�
upslope dike (G.2e) width plus rock � �K ,w„��
layer width (D.2) plus = �o,,,, w„�� �`��'••�
downslope dike width(G.ti); y� �_ ;� u�•������
�..�
0
/ '2 ft +�ft +�Sft= Zfeet �
k. Total mound length is the sum of oo nuoo�wwtn
_ ��.,�
upslope dike width (G.2e)plus rock layer
len h.(D.3)plus upslope dike width (G.2e); � . ��•�
�ft+�_ft +�ft = 7� feet - -
� _ �,.-
To�.��.�,��
owns opc ps ope
x� �i sa �i z> >:i �:i s:i s:� r.� e:�
s.�op�
0 7D l0 5.0 60 7.0 ).0 l0 S.0 �60 7.0 !D
1 �Di 117 5.?6 6J! 75] ZVI ].SS �76 S.E6 654 7.{t
2 �.19 t1S 556 6R D.II I.S7 J.7p �.51 536 it� 6.90
3 �30 l51 Sa! 7J2 !.!6 275 ]57 �.15 S.0! 5.79 b.15
� ]A1 U6 675 7.l9 9.T2 26! 7.15 l.17 �.bt 5.�6 6A6
S 7Sl 5.� L67 157 10.T7 261 �17 I.OD . 1.62 5.19 S71
� �i6 5.7b 7.1� 9JE 1207 25/ 3.27 3.65 1.11 �.7J S.�I
7 3d0 556 7.69 IOJI 17.7] 2.� 7.t2 1.70 �17 l70 5.13
! ].% 53! C37 115� 15.91 I.12 7.m 757 �.� �.�9 td!
1 �.11 �.25 9.W 17.0{ 1l.92 236 29� 7.15 J.9p t�p t65
. 10 �29 ♦67 10.0 IS.00 ' 27JJ 271 2!6 717 175 {.12 �M -
11 �A! . 7.1! li.11 1).SS ]O.0 21b 27E 7.D 7.61 ).95 {76
iz .�nn �.w ,zso z,.0 u.�s z�: z.�o �.,� �.�v �.eo �.a 64
.
PRESSURE DISTRIBUTION SYSTEM ' �
1. Select number of perforated laterals
2. Select perEoration spacing =_�_ ft.
3. Since perforations should not be placed closer than 1 ft. to
the edge of the rock layer (see p. E-14), subtract 2 ft. from the
rock layer length.
Rak`��ng�, -2 ft. _ ��ft.
�4. Determine the number of spaces between perforaHons.
Divide the length above by perforation spacing and round E-17a
down to nearest whole number.
TABLE OF PERFORATION DISCHARCES IN CP�'
Head PerEoration diameter(inches)
Length perf. spacing �� ft. �- 3 ft. _ �spaces �i3z ��a
�3� �2� t.0a 0.56 0.74
. 1.5 0.69 0.90
5. Number of perforations is equal to one plus the number of 2.ob o.so i.oa
2.5 0.89 1.17
perforation spaces . a.o o.9s ,.�s
4.0 1.13 1.47
5.0 1.26 1.6i
�spaces + 1 = I 7 perforations/lateral aUse 1.0 foot of head for residential svstems.
bUse 2.0 feet of head for other establishments
6. Multiply perforations per lateral by number of laterals to
get total number of perforations. • E-17b
3 // - wnae.n..�w..1d.r(� sa�a/a.��r�..l� �
-LL �ar<I0�A�iq�rw�a
laceral s x ��s�i��en,- s perforations. �;•�• 1.25 inch 1.5 inch 2.0 inch
2S 14 18 28
7. Deter.nine required flow rate by multiplying 3.o i3 i� �6
number of perforations by flow per perforation a.o ii is i3
(see page E -17) s.o io ia z�
S/ X ,7 =38 m.
�s �,���r gP E-15
�����d����
-�
8. If laterals are connected to header pipe as shown on page E-
�
15, select minimum required lateral diameter from table on
f�Y^
page E-17; enter table with perforation spacing and number �.-
of perforarions per lateral. Select minimum diameter for ✓"��
perforated lateral = 2 inches.
E-12
,--,�:..�:�-
9. If perforated latera� system is attached to manifold pipe near ���- ,.�
the center, a�: on page E-12, perforated lateral length and �"",�-_r'�
�
number oE perforations per lateral will be approximately one ""��'� �
...�:�
half oE that in step 8. Using these values, select minimum __ . ,,,r
diameter for perforated lateral from page E-17 as � �''� "'
inches. �✓
9
PUMP SELECTION PROCEDURE
A. Determine pump capacity:
Gravity Distribution
1. Minunum suggested is 20 gpm
2. Maximum suggested is 45 gpm Perforation Discharges in GPM
Head Perforation diameter
Pressure Distibution feec inches
3.a. Select number of perforated laterals �/32 1/4
b. Select perforation spacing= feet. 1.oa o.56 o.�a
c. Subtract 2 ft. from the rock layer length. 1.5 0.69 0.90
R��aY����g�-2 ft. = feet.
2.06 0.80 1.04
d. Determine the number of spaces between perforations. a Use i.o Eooc single homes.
Length perf.spacing= ft.= ft. = spaces
b Use 2.0 feet for anything else.
e. spaces+1 = perforations/lateral
f. Multiply perforations per lateral by number of laterals to
get total number of perforarions. �� x ��5�7= perforations.
$• T. X�m,a��r= SPm.
SELECT'ED PUMP CAPACITY 3S gpm
B.Determine head requirements:
1. Elevation difference between pump and point of discharge.
�feet
2. If pumping to a pressure distribution system,five feet for pressure S°�'�a°,�^�Sys�u^
required at manifold if gravity_sy_stem,zero. . Q;°'":'�:
�-' feet Total pipe lmgth
3. Friction loss
a. Enter frichon loss table with gpm and pipe diameter. � � n�,,;��,�
Read friction ss in feet per 100 feet from table(F-14). P`�
------- -- -
F.L. _ • ft./100 ft of pipe
.._....-�---..... . .
b. Determine total pipe length from pump to discharge --"'-'""'"-'""""----""-""'""--""'"
point. Estimate by adding 25 percent to pipe length for fitting
loss,or use a fitting loss chart(F-15 feet).
Equivalent pip�ength-1.25 times p p length=
6 X 1.25=��feet Friction Loss in Plastic Pipe
c. Calculate total friction loss by mulhplying Nominal
friction loss in ft/100 ft y equiva e t pipe length. � pipe dia.
Total friction loss=z��x�-100=___,��feet
4. Total head required is the sum of elevatior.diffe:ence, ���te 1.5" 2" 3"
special head requirements,and total friction loss.
�' 20 2.47 0.73 0.11
�+�+ •Z'S 25 3.73 1.11 0.16
(1) (2) (3c) 30 5.23 1.55 0.23
� 3�,1 6.96 2.06 0.30
TOTAL HEAD �feet 8.91 0.39
� 11.07 . 8 0.48
50 13.46 3.99 0.58
C. Pump selecEion 60 5.60 o.s2
65 6.48 0.95
70 7.44 1.09
1. A pump must be seleFte o deliver at least
�gpm (Step A) with at least/ feet of total head (Step B).
f
�izinQ of Pump Station ' .
1. Dctcrminc Surfacc Arca T
Rcctanglc=Ama=L x W W'��h
x = square feet 1
Lcnglh
Circle= Area=a x(Radius�
3.14 x x = squaze feet Radius
Other=Get Surface Area from Manufacturcr �=3.1a
square feet
�2. Calculate Gallons Pcr lnch
Thcre are 7S gallons per cubic foot of volumc,thcrcfore you must multiply the ama
times the conversion factor and divide by 12 inches per foot to calculate gallons per inch
Ama x 7.5 gpft'+12 inchs per foot
x 7.5+12 =�,�gallons/inch ��'�i£ �'�A',�L ��S
3. Calculate Gallons ro Cover Pump(with 2 inchcs of watcr covering pump) Es�imai«1 Scwage�lo�w)in Gallons per day
(Height(in)+2 inches) x gallons/inch(ii2)
(�+ Z )x � _ ��Z gallons um r
of Type I Typc II Type 11[ Typc
Iicdrooms 1 V
4. Calculate Total Pumpout Volume
a. To maximize pump lifc select sump size for 4 to 5 pump operations per day. 3 450 300 21�8 �
ob gpd+4= /d� gallons per dose 4 600 375 256 °r`�`
�.i��
b. Calculate drainback 5 750 450 294 ;,,
6 900 525 332 �Yr��,
1. Determine total pipe length,�S feet. 7 1050 600 370 "'"
2. Determine liquid volume of pipe, /� gallons per 1(x)f�Yt. 8 1200 675 408 ���,,,;,,�
3. Multiply length by volume: Drainback quantity=
3� fcet x�gallons/700 ft.__�gallons.
Pi d'umNa inchet Calluns r 100 fce�
c. Total pump out volume equals dose volume+drainhack 1 4.4
/�� eallons per dose+�_gallons= ���o gallons 1.25 7.77
1.5 10.58
5. Calculate Volume for Alarm(typically 2 to 3 inchcs) 2 17.43
Depth(in)x gallons/inc (#2)= 2.5 24.87
Z x 2.3 =�gallons 3 38.4
4 66.1
6. Calculate Reserve Capacity(75% the daily flow)
Daily flow(see page D-7)x.75=
�x.75=�gallons
7. Calculate total gallons
Rcservc Capacity
gallons over pump+gallons pumpout+gallons alarm+gallons mserve capcity
#3+ #4c+#5+#6
�L Z +/��+S[f�_+�b =�gallons A��
Pump On
8. Total Depth (Total gallon dividcd by gallon per inch)
Total Gal on(#7)+�allon inch(#t2) To I Pumpout�olumc
�7�+ 23 =�inches Pump Of�
Pump Hcight
9. Float Scparation Distancc(equal total pumpout volumc)
Total p�mpout volu�c)+�allons/inch(#2)
�� � 3 inches ,
f
�
� LOGS OF SOIL BORINGS
Location or Project 5�iz o ��h-i S,-��
Borings made by SWEDLUND Date �-22-0 /
Classification System: ❑AASHO 0 USDA-SCS ❑ Unified ❑Other
Auger used (check two): Q Hand ❑ or Power; ❑ Flight �or Bucket; ❑ Other
Depth, Boring Number � / Depth, Boring Number a Z
in feet Surface Elevation in feet Surface Elevation
p ' I7')t/ ♦ o p /Y)�l.t�s E �/ 11� /L
ollZ ��,� �/L al� .��� ��Z
, - /Z/ �J ' - /� S�1. �.a,4,K y1�l
Z� S�Z ,4�,4M, /� / �
2 - 2 2 - 30
y L'/�1 �S' �
3 — 3 — /�1 O � �E. �
l� '�
�o%i�d ,�� �s
4 - ,��, A �� �' 4 - ��z
d ��Z �- ---
5 — 5 —
6 — 6 —
7 — 7 —
8 — 8 —
9 — 9 —
10 — 10 —
End of boring at 2/ feet. End of boring at Z !L feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
� Not present in boring hole. �l Not present in boring hole.
� �
Mottled Soil: � ,� Mottled Soil: � ,�
❑ Observed at�feet of depth. ❑ Observed at�feet of depth.
❑ Not present in boring hole. ❑ Not present in boring hole.
�
LOGS OF SOIL BORINGS �
Location or Project �7z D �6�i u S i��
Borings made by SWEDLUND Date (e—ZZ —� �
Classification System: ❑AASHO 0 USDA-SCS ❑ Unified ❑Other
Auger used (check two): Q Hand ❑ or Power; ❑ Flight 0 or Bucket; ❑ Other
Depth, Boring Number Depth, Boring Number � �
in feet Surface Elevation in feet Surface Elevation
p ' U�vs � o � „�s� �l 1 v 2.
��a �� ! Z ��Z �,� Z�Z
1 — 1 — /
l� � ;.z.� �� ���� �2 0�;.L� �a►-�9�- 9 l�
2 — 2 — �
3� � J /�// � � .�
/�'1 D 1/ � cl� l'1'1 a //�-E c1 /Co
3 — 3 —
�h �i� � ��s ��2 �2l,� �.��.�S
4 — 4 —
5 — 5 —
6 — 6 —
7 — 7 —
8 — 8 —
9 — 9 —
10 — 10 —
End of boring at z/Z feet. End of boring at 2 /� feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
❑ Not present in boring hole. ❑ Not present in boring hole.
Mottled Soil: Mottled Soil:
❑ Observed at feet of depth. ❑ Observed at feet of depth.
❑ Not present in boring hole. ❑ Not present in boring hole.
Dat� . C�2Z—o / PERC TEST BY SWEDLUND SEPTIC
Location �720 �A..,S I� Hole # � Depth �2 ��
Soil Depth O - /Z.. Texture .Lo�-�✓
Depth of Initial
Water Filling �o ��
Perc Test starting Time and Date: Time 1.oo Date G-Z Z.�-o /
Time Intervals Drop in Inches Perc Rate
!_ 2 0 �,,,,�„ ��� �p/'+ i
t� y� „ y ,
.� .
S�o_ Z �► •, •
Date lv-2Z-o I PERC TEST BY SWEDLUND SEPTIC
Location _ ��t n�� Hole # .2 Depth /Z��
Soil Depth Q -/Z Texture ��-•�
Depth of Initial
Water Filling /o'
Perc Test starting Time and Date: Time %'ao Date �-2 Z�b /
Time Intervals Drop in Inches Perc Rate
- /:so Zoa.. 7 � �; ,
M i
r. pd .i 7 .
go_ Z �i �7 �,
Date �v Z2—o � PERC TEST BY SWEDLUND SEPTIC
Location �Ar-�� Hole # � Depth �2 ��
Soil Depth O-/Z Texture �0�4-�
Depth of Initial
Water Filling �o '
Perc Test starting Time and Date: Time /'oo Date G-2 L-c /
Time Intervals Drop in Inches Perc Rate
�° 3� 2 ..� is - �,�, :
� � �
_ ,, o� �
so� 2 •o i< .
.,,� .
Dat� (-Z2— o � PERC TEST BY SWEDLUND SEQTIC
// .�
Location y 7z0 G�-jS� � Hole # �' Depth �z
Soii Depth O—/Z Te�ure ��s,4�1
Depth of Initial ��
Water Filling ��
Perc Test starting Time and Date: Time /.�o o Date �-7Z-o /
Time Intervals Drop in Inches Perc Rate
io 30 �
Zv •�--- s 7 -... .
� 3• �� ,. t '
_ Z m��
.j-o.. Z .. �i 3
Z 7 Kt i
�ate � PERC TEST BY SWEDLUND SEPTIC
Location Hole # Depth
Soil Depth Texture
Depth of Initial
Water Filling
Perc Test starting Time and Date: Time Date
Time Intervals Drop in Inches Perc Rate
Date PERC TEST BY SWEDLUND SEPTIC
Location Hole # Depth
Soil Depth Texture
Depth of Initial
Water Filling
Perc Test starting Time and Date: Time Date
Time Intervals Drop in Inches Perc Rate
f
DATE TIME
CITY OF ORONO \ CALLED IN
INSPECTION NOTICErr ; �""'U SCHEDULED 9-Ia�O f %3 C%
PERMITNO. '� J`j � COMPLETED �''�G�'i', �"'"� '
ADDRESS y��d ` S'� � � I
OWNER CONTR. �`" �d '`����
TELEPHONE NO.
� DESCRIPTION ��'`^\��
ty� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 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
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL �5 EPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI EPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
J
Q OWNERICONTRACTOR TO MEET YOU: YES_NO
Z
� COMMENTS:
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0 BEFORECOVERING PERMANENT
[l CORRECT UNSAFE CONDITION WITHIN HOURS. ;-, PHOTO TAKEN
INSPECTOR WILL RETURN
�' rITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hl urs in adva�ce. Z49-4600
OwnerlContrac�or on site: '�'' 4 I
a
Inspector.
•' ������� ,,i„�`- � �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC�� ��i^��SCHEDULED �-J�,-db � ' !S�
PERMIT NO. '`�� �' � �� coMP�ETE� ' 1 � �� - � � '
ADDRESS � t� � '
OWNER CONTR. �`�e� �� '
TELEPHONE NO.
� DESCRIPTION �l'_p �.( — /�.0{� �,�if
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 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
Z
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 EPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTI FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YO YES_NO
� COMMENTS: � ����%�l�; �; � ` � i
W � i � , :� f� ��
� � ���
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W
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. , pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDERPOSTED.CALLINSPECTOR f CITATIONISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. 249-4600
i
OwnerlContractor on site: '
Inspector. � '
� White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO , CALLED IN
INSPECTION NOTIC � : �'�,�;J'iJ SCHEDULED q-��3•�f � -3 C��
PERMIT NO. � � COMPLETED ^1�'�� � �'� G�
ADDRESS � S�c��
OWNER CONTR. �������
TELEPHONE N0.
� DESCRIPTION �ZD k.L �/ V
ly� 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 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
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE �SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL �'-1
�,tiibEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO M ET YO YES_NO
Z �/
� COMMENTS: �� `''��`` " `�� � f�
� ` `'�c' . � r�%
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d�WORK SATISFACTORY:PRO D � !� TE
� C i CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFIC F OCCUPANCY
W
O Cl CORRECT WOf1K,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORFIECT UNSAFE CONDITION WITHIN HOURS. i- PHOTO TAKEN
INSPECTOR WILL RETURN
C] STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
��� INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector. �J 1`������� ! �`�''��`�'�--
White Copyllnspector's File Canary CopylSite Notice
— --- --�_---_---
�ERIVIIT _
CITY OF ORONO
1335 Brown Rd. South • P.o. BoX ss PERMIT TYPE: ���.���.r�lr���
Crystal Bay, Minnesota 55323 Permit Number: Cii 3i f�ftj�,�
� _ (612) 473-7357 Date Issued: ci;�;/i;_;/r;7
�IT� ,�n���SS:
�;:_�"' �.�i'�:=�I C�+__ �I:;
�.Z�- 3�-//$� � 'S 33 000 �
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CONTRACTOR:
OWNER: __ ��:.�,a. � ���lt. --
c_�c ic 1�i�.r�_rc i�_, i:hEY �
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APPLICANT/PERMITEE SIGN URE
ISSUED BY SI ATURE �
INSPECTION I�ECURD
CITY OF ORONO PERMIT TYPE: > '`�v�
1335 Brown Rd. South • P.O. Box 66 Permit Number: ;;.�
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS: APPLICANT: �'
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CITY OF ORONO CALLED IN � ���
INSPECTION NOTICE SCHEDULED CS-��� ���
PERMIT NO. ��� z— COMPLETED -5 " �� � ��
ADDRESS �
OWNER L-' CONTR.
TELEPHONE NO. � �� �- 3ln('15
❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING O PLUMBING FINAL ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS
� ❑•WALL BD. ❑ WATER HOOKUP ❑ LICENSING
lV 'J�FINAL ❑ METER SET/TURN ON ❑ COMPLAINT
� t� PROGRESS L7 SEWER HOOKUP ❑ FOLLOW-UP
� ❑ DEMOI. ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL
Q ❑ FIRE PREV. ❑ SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER
� ❑ WELL TEST PUMP ❑
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� �CQRRECT WORK 8 PROCEED
OU,/� CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
� CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN.
� STOP ORDER POSTED.CALL INSPECTOR.
u �NSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. o site
Inspector � ��'+^� 473-7357
White/Inspector's File Canary/Site Notice