HomeMy WebLinkAbout1989-10-04 Application for Septic PermitAPPLICATION FOR SHPTIC SYSTEM PERMIT
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CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay^ MN 55323
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General Instructions: . > . .
1. You may acrIv for septic system permits by mail or in person at the
City offices. However, permits will not be mailed out 2md must be
piched up in person at the City offices.
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6.
Permits are not valid until you receive a permit card.
WorJc must not begin unless the permit card is available on the job
site.
Permits will be issued only to contractors holding a City of Orono
Septic System Installer's License.
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.
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
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
all inspections. 24-hour notice is required for all inspections.
JOB SITE ADDRESS:/ 2, (9 3( irr-k
OtherOccupancy Type: Residential X Commercial_ _ _ _ _ _
Owner's Name; T (f rr/ Q i\id o _ _ _ _ _ _ _ _ _ _ _Phone: ^ 3 i' Of 0^
Mailing Address: /6 6^ccl.'\tOr City: M_ _ _ _ Zip:
Septic Contractor's Name:Cloc'cr ///// ^I Bus. Phonef
Mailing Address: •i\'l I 3 ? 2 ________ City; • Zip^^|_^^^l
- over -
!70TS: Applicant must initial all spaces. Fill in all acnropriate blanksr
check all appropriate boxes.
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SSFTXC STSTSH PBIiHIT AFFUCATOR - FAG2 2
Permit Type & Fees (check one)
New Constructionr Full System $75.00. . . . . . . . . . .. .. . . . . ..
Hep lace Existing System (1 or more new tanks & drainfield) $50.00. . .
Partial Replacement (replace just tanks or just drainfield) $30.00. . .
50.50 State surcharge added to above permit fees
SEE FEE SCHEDULE FOR NON-RESIDENTIAL PERMIT FEES
DO HOT MAIL PAYMEMT HITH THIS APPLICATION
:ni tial
(LtO 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: 3 Precast v.oncrete ___^Other Manufacturer
Tank Capacities: 1) / cal. 2) jbcp cal. 3) cal.
B.Pump Station (if required)
Pump make & model/W^jWic
I
S7’ 0 iX>ti
<:■
______________________ (attach pump curve &
literature); system design requires vo cum at il,T feet
of head. High water alatm make fi model At^cUor 2.0^ _.
Outside electrical work to be completed by _installer
yelectrician __pother, _j_________. Inside electrical work
must be completed by electrician.
c.Treatment System:
Trenches: s.f. ^ _ __ _ _
Depth of rock below pipe Rock bed dimensions *x *
_ _ Drop Boxes Sand bed dimensions *x_ _*
Mound
Distribution Box Pressure Dist. Pipe Diam.
Manifold Pipe Diam.
m
m
D. Final Cover/Topsoil to be:
X
borrowed from site
. (show location on site plan)
trucked in
s undersigned hereby applies to the City of Orono for issuance of a
.:tic system installation per 't, agrees to do all work in strict
:ordance with the ordinamees of the City and the regulations of the State
MinnesotSf and certifies that all statements made on this application
completer, true and ^'rrect.
latur^ of Applicant:,01 Date: fl) ~
4 Certification No.: /5~7 2^
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