HomeMy WebLinkAbout1992-06-29 Application for Septic Permit00 -
APPLICATION FOR SEPTIC SYSTEM PERMIT
CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
General Instructions:
1. You may app. y 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
d^sign. 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
(sand will be jar tested for silt content), 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 MPCA Installer Certificate shall be present during
installation. 24-hour notice is required for all inspections.
JOB SITE ADDRESS: `Sv C rte'�%C "��"�� 7-P C --
Occupancy Type: Residential Commercial Other
Owner's Name:- yI1 �` Phone.
Mailing Address:
City: Zip:
Septic Contractor's Name:A�tyc'S 5�'��s ��C Bus. Phone:
Mailing Address: �, / !jox 2-0 2. City: untr- <e Zip:
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SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2
Permit Type a Fees (check one)
New Construction, Full System $100.00 . . . . . . . . . . . . . .
Repair or Replace Existing System $50.00 . . . . . . . . . . . . .
$0.50 State surcharge added to above permit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT !TAIL PAYMENT WITH THIS APPLICATION
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NOTE: 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.
A.
B.
1 LlJrde inn f,* /-C
I will be installing the following:
Tanks: Precast Concrete Other Manufacturer
Tank Capacities: 1) 12-5-0 gal. 2 ) JO(,0 gal. 3 ) JSGO gal.
Pump Station (if required) i�
Pump make & model O.ClJd LOEOS1k ,P ' (attach pum . curve &
literature); system design requires Z qpm at .27 _ feet
of head. High water alarm make & model �.e�zlARw. - ")LV
Outside electrical work to be completed by _installer
.X electrician _other In -de electrical work
must be completed by electrician.
C. Treatment System:
�,
Trenches: s.f.
04A Mound
t O '
Depth of rock below pipe
Rock bed
dimensions
x'7S'
Drop Boxes
Sand bed
dimensions
33'" x AoV
Distribution Box
Pressure
Dist. Pipe
Diam.
Manifold
Pipe Diam.
9 "
D. Final Cover/Topsoil to be: 3t4 borrowed from site
sc,1 fib. bdo-tw%&- t - tti.Q,�,% t ( show location on site plan)
C...ck Sa,v.Q ,� I bt 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.
Signature of Applicant: 1Date: 2
MPCU Certification No.: �� �T