HomeMy WebLinkAbout1990-06-01 Application for Septic PermitI
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application for sbptic system permit
CITY op ORONO
Box €6 (1335 So Brown Rd)
Crystal Bay, MN 55323
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General Instructions:
1. You nay aggly for septic system permits by mail or in person at the
City offices. However, peraits will not be nailed out and nust be
picked np In person at the City offices.
2.
3.
Permits are not valid until you receive a permit card.
Work must not begin unless the permit card is available on the job
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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)
c)
Tank installation prior to covering.
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
installation in the rock bed.)
d)Pinal 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
^jll^inspections.^^24-hour notice is required for all inspections.
JOB SITE ADDRESS: :^30Z> ^
Occupancy Type: Residential
Owner's Nane: L t o fS ^ y
Commercial Other
Nailing Address:
Phone:
City:Zip:
Septic Contractor's Name: /C n i dc iv j,c/ ■& )(C Z/nyBus. Phone:
' 1 _______^Citv: ^ Zip:
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8BPTXC SYSTEM PERMIT APPLICATOH - PAGE 2
Perait Type ft Fees (check one)
Mew Construction, Full System $75.00. . . . . . . . . . . . . . . . . . . . . . .
Replace Existing System (1 or more new tanks & drainfield) $50.00. . .
Partial Replacement (replace just tanks or just drainfield) $30.00. . .
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$0.50 State surcharge added to above permit fees
SEE FEE SCHEDULE FOR NOM-RESIDENTIAL PERMIT FEES
DO MOT MAIL PAYMENT MITE THIS APPLICATION
MOTES Applicant must initial all spaces,
check all appropriate boxes.
Fill in all appropriate blanks.
Initial
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. Tanka: Precast Concrete ___^Other Manufacturer
Tank Capacities: 1)gal. 2).gal. 3)gal.
B.Pump Station (if required) ,
Pump make & modelU* ijuiTF;?* >.7^ ill
literature); system design requires _ _
of head. High water alarm make & model
_ (attach pump curve & ^
HC\_gpm at feet
Outside electrical work to be completed by install^
i/felectrician __pother____________. Inside electrical work
must be completed by electrician.
c.Treatment System:
Trenches:s. f.t
Depth of rock below pipe
_ _ Drop Boxes
Distribution Box
_ _ Mound ^
" Rock bed dimensions fO *x ?7 *
Sand bed dimensions u r *x ir*r*
Pressure Dist. Pipe Diam. fV>-"
Manifold Pipe Diam. 7^
D. Final Cover/Topsoil to be:borrowed from site
(show locat^n on site plan)
trucked in
>cat^]
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: A V
NPCA Certification No.:
Date:tn-t- TO
OK- issue
//vsp copy
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CZTT OF OROMO
septic system APPROfVEL
Permit
Fee $__I
Entered Bp
Th« Contractor will bo glwon a copy of thin report and la
resDonalbla for Ita dlatrlbntlon to all anb-contraetora. Septic ayataa
deaign la not oonaidcred aa approeod imleaa thia aheet la attached.
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'4-cwansM, CORntBCTORs,V7S--^7/<9 I
SEPTIC CORTRACTQR:.PHONE:
/P </7^ -yo'72^
□^APPROVED
Tg^ONDITIONALLY APPROVED: Note Changes Below
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l>S7Xf6uT7Q^J ^yirgV^ »^iXST ^yrvjT?/^ ________________
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NOTICE TO INSTALLERS: Any changes to the approved plan and specs must have
prior approval of the Inspector (473-7357). Call for inspections 24 hours
in advance.
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/.HOTZCB TO GENERAL CONTRACTORS: Drainfield sites must be protected prior to
>^nd after system installation to avoid compaction of the natural soil.
^ Drainfield areas must be fenced off to eliminate all traffic over them.
/Z'12,'81
Date Approved By
4
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