HomeMy WebLinkAbout1990-06-26 Application Septic System Permitcc)(>Lf
APPLICATION FM SEPTIC STSTaII PERKIT Aft
CITT or OAONO
Bos ii (1335 So Brown Ad)
Crystal Bay, M 55323 M�►
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General Instructions:
1. You may avyly for septic system permits by mail or in person at the
City offices. Bowever, permits will not be mailed out and must be
picked op in person at the City offices.
Z. 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 accordart :e 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.
G. 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
insta 1 lation =n—the rock bed.)
d) Final inspection to verify proper f°nal 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
all inspections. 24-hour notice is required for all inspections.
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J00 SITS ADDAlSSs z: 17
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Occupancy Type: Residential Commercial Other
Owner' s Name: ClIL"A ��»u-1 Phone: q 7?
Mailing Address: fZy G ���e:�, /' City: .,.�., /�, zip: 5=�
Septic Contractor's Name: C/� c� �1 �� < < �N� Bus. Phone: J7- x7
Mailing Address :9f 1 t3L` ' �� City: U) «cam Zip: S S�y
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SQ?IC SYS?= Pl ? APPLICATM - PAGE 2
Pemit Type i Fees (check one)
New Construction, Fr41'System $75.00. . . . . . . . . . . . . . . . . .
Replace Existinj hystem (1 or more new tanks i drainfield) $50.00. . .
Partial Replacement (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 WT MAIL PAMW WITH THIS, APPLICATION
NO'+'s: Applicant must initial all spaces. Fill in all appropriate blanks,
check all appropriate boxes.
initial
PtO 1. I have received a copy of the system design including the
:.'ity of Orono Septic System Approval Cover Sheet.
2. I will be installing the following:
A. Tenks: Precast Concrete Other Manufacturer! _
Tank Capacities: 1) is gal . 2 ) _ gal. 3 ) /SOT, gal.
B. Pump Station (if required)
Pump make model 4 .a rw.f i[. 1P) D ( attach pump curve
literatuse)s system design requires �� 5Fm at Y%L, feet
of head. High water alarm make i mode To--t SWC _.
Outside electrical work to be completed by —installer
electrician other . Inside electrical work
must be completed by electrician.
C. Treatment System:
' •enches: s . f . Mound
Deg of rock below pipe Rock bed dimensions L'x_L2'
Drop Boxes Sand bed dimensions 'x i2.'
Distribution Box Pressure Dist. Pipe D ll .1V c
Manifold Pipe Diam. L
D. Final Cover/Topsoil to be:X � borrowed from site
q% (show location site pla )
trucked in
The undersigned hereby applies to the City of Orono for issuance of a
septic system installation permit, agrees t to all work in strict
accordance with the ordinances of the City and t: •qulations of the State
of Minnesota, and certifies that all statements it on this application
are complete, true and correct.
Signature of Applicant: G' �-
NICA Certification No.: 1 `> > .?
Date:
ice