HomeMy WebLinkAbout1993-06-02 Permit, Septic System #005201PERMIT
CITY OF ORONO
2750 Kelley Parkway • P.O. Box 815
Orono, Minnesota 55356-0815
(612) 473-7357
SITE ADDRESS:
1r,.5
LSV
DESCRIPTION:
FOX SF
PERMIT TYPE:
Permit Number:
Date Issued:
NEW SYSTEM
'.:ewer &{ Water Pei-rliit. Type NEW SEPTIC: SYSTE
'_:ewer & Watts We-rk: Type RE'_:IDENC:E
REMARKS:
,:EWER & WATER
oCl.5*2i11
CITY OF MW
t IMW OFFICE
1 JIBOM J
Ora 11"Av
1««00400 J
01 4M .50
cck R 100.50
RECEIPT-TM4l * YOU
#2 745b0 C001 R01 T 007:
FEE SUMMARY: i
Base Fee $1(T() 00
'_:urchar-3,—I�.��L)
Tc-tal Fee-------$100.50
CONTRACTOR: - App 1 i c all t - OWNER:
PETER'_:C' iN ELMER _T caj 54718151 JENSEN HOMEr:
5921 DAGUE AVE '=:F_ 900 WAYZATA BLVD E
DELANO MN SS:=:28' WAYZATA MN 55391
c 612':> 4 71-:31.51
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO Di i ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO ORDINANCES AND STATE OF MINNESCiTA BUILDING CODE REQUIREMENTS.
L_
APPLICANT ERMITE IGNATURE ISSUEDBV SIGNATURE
APPLICATION FOR SEPTIC SYSTEM PERMIT
CITY OF ORONO
Boa 66 (1335 So BroMn Rd)
Crystal Bay, MM 55323
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr:rrrrrrrrrrrrrrrr
General Instructions:
1. You may apply 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 orifices.
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 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.
rrrrrrrrrrrrrrrrrrrrrrrrrrrr*•rrrrrrrrrrrrrrrrrrrrrrrrrrrr:rrrrrrrrrrrrrrrr
JOB SITE ADDRESS: lot 3 block 1 Hanser addition
Occupancy Type: Residential X Commercial Other
Owner's Name: Jensen homes Phone:
Mailing Address:WayiatA City: Orono Zip:55391
Septic Contractor's Name: Elmer J Peterson Due. Phone l718151
Mailing Address: 5921Dague ave City: Delano Zipt55328
rrrrrrrrrrrrrrrr ::rrrr rrr*r�iT
- over -
4�yc;lt"� J,
SEPTIC SYSTEM PERMIT APPLICATON - PAGE 2
Permit Type i Fees (check one)
x
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 MAIL PAYMENT WITH THIS APPLICATION
•:::*:****eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee*ee*::*ee*eee:::*:**:*eee**
MOTE: Applicant must initial all spaces. Fill in all appropriate blanks,
check all appropriate boxes.
initial
no 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: x Precast Concrete other Manufacturer
Tank Capacities: 1 100d gal. 2 1250 gal. 3)12,1.9.._gal.
B. Pump Station (if required)
Pump make 6 model blue angle 40 (attach pump curve i
literature); system design requires 57.7gpm at 18.5 _ feet
of head. High water alarm make i model •
Outside electrical work to be complete y installer
_electrician _X_other Inside electrical work
must be completed by electrician.
C. Treatment System:
Trenches: s.f.
Depth of rock =e ov pipe
Drop Boxes
Distribution Box
Mound
Rock bed dimensions �,' x�'
Sand bed dimensions ' x,9, -
Pressure Dist. Pipe D am.,"
Manifold Pipe Diam. _2
D. Final Cover/Topsoil to be: borrow from site
(show location on site plan)
x trucked in
•eeeeeeeeeeeeea*:ee:::ee*eee*�**:::eeee:*eese:see*eeeee**:eeeee*:::eseee*:*
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: Dats
813
MPCA Certification No.: 0