HomeMy WebLinkAbout1989-11-08 Application for Septic System PermitV=C =ON FOR SSMC
SYSTEN PERMIT
CITY OF ORONO
Boz 66 (1335 So Brown Rd)
Crystal Bay, 14N - 55323
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General Instructions: -
1. You may arr. Iv_ for septic system permits by mail or in person at the
City offices. However, permits will not be mailed 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 job
site.
4. Permits will be issued only to contractors holding a City of Orono
Septic System Installer's License.
5. All work must be done in accordance with the approved septic system
,resign. Design reports are not considered approved unless accompanied
by the "City of Orono Septic System Approval" cover sheet signed by
the City Inspector.
6. 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, and again during pressure distribution piping
installation in the rock bed.)
d) Final inspection to verify proper final cover depths and to
verify that all pump station (where required) components are
functional and comply with codes.
7. Individual holding MPGA Installer Certificate sha1J be present during
all inspections. 24-hour notice is required for all inspections.
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JOB SITE ADDRESS: ?j 7 ` s �j ri S ► n ✓r
Occupancy Type: Residential`Y Commercial Other C
Owner's Name: I`) eyi !G[ G�' s Phone : 6 7 % / y-3
Mailing Address: City: Zips_
Septic Contractor's Name: C-0 Bus. Phone:
Mailing Address: 3 7Z A City: zips
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-771 7117.
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SEMP=C SYST3 .PEWaT APPLICATOR - PAGZ 2
Permit Type & Fees (check one)
New Construction, Full System $75.00. . . . . . .
Replace Existing System (1 or more new tanks & drainfield)
Partial Reclacement (replace just tanks or just drainfield) $30.00. .
$0.50 State surcharge added to above permit. fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT MAIL PA2WMT WITH THIS APPLICATION
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NOT8s Applicant must initial all spaces. Fill in all appropriate blanks,
check all appropriate boxes.
initial
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 G
Tank Capacities: 1) gal. 2) gal. 3) _,00 gal.
B. Pump Station (if re it d 3 (
p curve &
h
Pump make & model 5 (attach pum
literature); system design requiresy gpm at /3 feet
of head. High water alarm make & model 7rs' gh.�. r .
Outside electrical work to be completed by installer
electrician other . Inside electrical work
must be completed by electrician.
C. Treatment System:
Trenches: s.f.
Depth of rock below pipe "
Drop Boxes
Distribution Box
K Mound
Rock bed dimensions /O' xSr'
Sand bed dimensions &d'x=__'
Pressure Dist. Pipe Diam.,LL"
Manifold Pipe Diam. 2--
D. Final Cover/Topsoil to be: borrowed from site
. (show location on site plan)
_ trucked in
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he undersigned hereby applies to the City of Orono for issuance of a
sptic system Installation permit, agrees to do all work in strict
zcordance with the ordinances of the City and the regulations of the State
Minnesota, and certifies that all statements made on this application
_e complete,. true and correct.
:gnature of Applicant: �Cu�YuX�F' oc ��`' Date:
'CA Certification No.: /S 72-