HomeMy WebLinkAbout1992-04-27 Application for Septic System Permitw
application for septic system permit
CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
General Instructions:
1. You may apply for septic system permits by mail or in person at the
City offices. However, pemlts will not be nailed out and must be
picked up in person at the City offices.
2. Permits are not valid until you receive a permit card.
3. Work must not begin unless the permit card is available on the iob
site.
4.
5.
6.
Permits will be Issued only to contractors holding a City of Orono
Septic System Installer's License.
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.
The following inspections will be required for all septic systems;
a) Pre-installation site inspection to include Inspector, Installer,
and general contractor.
b) Tank installation prior to covering.
c) Drainfield trench installation prior to covering. For mounds,
inspection is required after rough-up but prior to sand placement
(sand will be jar tested for silt content), and again during
pressure distribution piping installation in the rock bed.
d) Pinal inspection to verify proper final cover depths and to
verify that alx pump station (where required) components are
functional and comply with codes.
7. Individual holding MPCA Installer Certificate shall be present during
installation. 24-hour notice is required for all inspections.
JOB SITE ADDRESS:i / t/O i'/ /O.
Occupancy Type: Residential Xv
Owner's Name:
Commercial Other
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Mailing Address;
a
Septxc Contractor's Neune:
Phone:
Zip:,, City:, C^^
\T [J________ Bus. Phone;
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SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2
Permit Type fi Fees (check, one)
New Construction, Full System $100.00 .
Repair or Replace Existing System $50.00
$0.5C State surcharge added to above permit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT PEES
DO NOT MAIL PAYMENT WITH THIS APPLICATION
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks,
check all appropriate boxes.
Initial
1.
2.
A.
B.
C.
I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
Manufacturer
I will be installing the following:
T2mks: y Precast Concrete _ _^Other _ _ _ _ _ _
Tank Capacities: 1) gal. 2) gal. 3)gal.
Pump Station (if required)
Pump make & model_ _ _ _ _(attach pum{> curve &
literature); system design requires c/p gpm at j'? feet
of head. High water alarm make & model
(^tside electrical work to be complete by '^instSller
^ electrician __pother_____________. Inside electrical work
must be completed by electrician.
Treatment System:
_ _ Trenches:_ _ _ _s.f.
Depth of rock below pipe
_ _ Drop Boxes
Distribution Box
D. Final Cover/Topsoil to be:
Mound ^
Rock bed dimensions //) *x>>^ *
Sand bed dimensions *x *
Pressure Dist. Pipe ^am.
Manifold Pipe Diam. "
X
borrowed from site
(show location on site plan)
trucked in
The undersigned hereby applies to the City of Orono for issuance of a
septic system installation permit, agrees to do all work in strict
accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application
are complete, true and correct.
Q
Signature of Applicant
MPCA Certification No-: AzO / J
Date