HomeMy WebLinkAbout1992-03-02 Application for Septic Permitil��
APPLICATION FOR SEPTIC SYSTEM PERMIT � �-f
CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay, NN 55323
General Instructions:
1. You may apply for septic system permits by mail or in person at the
City offices. However, permits will not be sailed 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
design. 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 contras: nor.
b) Tank installation prior to covering.
c) Drainfield trench installation prior to covering. For mounds,
ir.�pection 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.
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JOB SITE ADDRESS: q7
Occupancy Type: Residential �� Commercial Other
Owner's Name: (` ��Y� , L�l�, Phone:
Mailing Address: City: Zip:
Septic Contractor's Name:&,e,& d A 6c11i wao Bus. Phone: '?7
Mailing Address: //s��s �a���' �� City:
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SEPTIC SYSTEM PERMIT APPLICATOR - PAGE 2
Permit Type i Fees (check one)
New Constructicl, 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
ROTE: Applicant must initial al. spaces. Fill in all appropriate blanks,
check all appropriate boxes.
Inktial
1. I ha.,e received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
2. I will be installing the following: Z�
A. Tanks: f/ r recast Concrete vOther Manfifacturer
Tank Capacities: 1) /off 5D gal. 2) DD gal. 3) 1� g 1.
B. Pump Station (if required)
Pump make & model 4j!w (attach p ump urve &
literature); system des g requires at6 0 feet
of head. High water alarm make & model
Outside electrical work to be completed by installer
,&lectrician _other Inside electrical work
must be completed by electrician.
C. Treatment System:
Trenches: s . f .
Depth of rock below pipe "
Drop Boxes
Distribution Box
x Mound ��.
R ck bed dimensions 'x '
Sand bed dimension s�'x�'
Pressure Dist. ripe D am'�"
Manifold Pipe Diam %&_
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan)
trucked in
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The undersigned hereby applies to the City of Orono for issuance of a
septic system installaticn permit, agrees to do all work in strict
accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifie hat all statements made on this application
are complete, true and co ec .
Signature of Applicant: Date: J onr-)
MPCA Certification No.: P,'n2 ✓