HomeMy WebLinkAbout1996-08-16 Application for Septic PermitBate " (2730 Kelley Parkway)
Cry" Bp►, NIN SS323
JOB SITE ADDRM:"-
Oacttpncy Type: MUM MM lI CattettsnM Other
Pank Type: New or —0Systear, $146.40 4epair Esletiae Syeters, i N.N
(Tmb or Drd@W
0.* State arelraepe ant" to dole Men
*See fee scbWWk ter ttoa-redtle■tiai peratit fen
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Addran -S 2 t4 5 Y. Cltno' . 2
DO NOT 1NAII. PAYMENT YAM TM APMXATION
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I. Appikatiom for septic system permits may be maned or submitted in person at the City
Offices; however, perms will not be mailed out. The permit must be picW up in
person at the City Offices and work must not be& unless stet permit card is on the job
Sit-.
2. Pie mb will be issued only to coatraetors holding a City of Orono Septic System
Imullers License.
3. ' 11 w►o& must be done in accordance with the approved septic system design. Dniga
ports are not comdered approved unless accompanied by the "City of Or+ow Septic
-yaw ' Vroval" cover shut sipaed by the City Impeclor.
4. The following impectons will be nVured for all septic systems:
A. Pre -installation site snpoaiom to inchde inspector, i utalkr, and general eoatractor.
B. Tank haulistioa pi-ior to coveritK.
C. Drainfield trench installation prior to eoveritwg. For mound:, inspection is re*dred
after rough -up but prior to sand placsmtew (sand will be jar tested for silt cooeent),
Ed a,pain during prasue distribution piping instillation in the rock bed.
D. Fiml inopection to verity proper fioal cover depths and to verify that all pump station
(where required) components are ftuctiovW and comply w►idt codes.
IrAvidaal holding beCA Instilkr Ceruiicase dull be present during impecu m. A 24-
botrr .oboe is ngvkw for ON kweetisas.
- "0
NOTE: Applicant most initial all spaces.. Fill in all appropriate blanks, check all -pp upcia
boxes.
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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 Manufacum
Tank Capacities: ,I) gal. 2) gal. • 3) gal.
1 ".
B. Pump Station (if required)
Pump make & model __/[ : • i " (attach pump curve &
literature); system design negn Tres 3 ; gpm at feet of bead.
High water alarm make & model t - 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 so
Drop Boxes
Distribution Box
Mound
Rock bed dimensions i o 'x hL'
Sand bed dimensions ,. - 'x y a
Pressure Dist. Pipe Dam. _ w
Maniford Pipe Dram. z
D. Final Cover/Topsod 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 syteeem 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 compiese, true and correct.
SignatmofApplicant: Date:
AMA Certification X ") `/
Staff Review: Appnwai _ Dodd
Dam C:
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