HomeMy WebLinkAbout1994-10-26 App. & Permit, Septic System #006571PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO. Box 66
Crystal Bay, Minnesota 55,123
(6'2)473-7357
OM ADDRESS:
PERMIT TYPE:
Permit Number: '' 6 F4 h WATER
� fir;.,, 1
Date Issued: i t:►;F •�4
61,i l 13ANOEF' RIB
L1-11 v
` DESCRIPTION:
._;EPTIC ;YSTEM
Sewer h Water Permit Type NEW SEPTIC ,*Y'=.i'E:
Sewer h Water Wcirl; Type RE`;IDE:N :E
REMARKS:
FEE SUMMARY:
Base Fee $10(, 00
►
Surcharge ----------- 1—.c)
Total Fee $ 100 . So
CONTRACTOR:
W I DME R BROS INC:
Pn BI)X
_tNIFAC: IUS
CI T'r OFRC1Va
F,,"NA iCE UFICE
01 rEV 100.00
A 4 4:9:4:. 00000 N
01 aw .50
NECK TL 1 uL'
RE1E1FT-Tt4oWA' YOU
#31 7330 C001 RN T11:46
10,rb,'94
�� p i c Kn t. OWNER:
SA46149 t-)- ;F I'EI- ►.
219 650 GANDER PCB
MN =.5:j7 S i ►kC►NC► MN
THE 1 '=-.R1=PY RE Q(+.STS PERMISSION TO MAKE THE REEAL I MPROVEhPE NTH;
:- PE.0 I F I ED :)NO A - RI' , T►_I Of, Ai L WORK IN STR , t_ .r COMPLIANCE WITH ALL CITY 13F
URA INS:► 0801 NANO -Lb PNL► '-:'f ATE OF M I NNE c.OTA BUILDING CODE REQUIREMENTS.
L
APPUCANT.PERMITEE SCOW URE ISSUEDBY SIGNATURE
NOTE: Applicant must initial all spaces. Fill in all appropriate blanks, check all appropriate
boxes.
1. I have received a copy of the system design including the City of Orono
Septic System Approval Cover Sheet.
2. I will be installin&jhe following:
Manufacturer
A. Tanks: /Precast Concrete _
Other
2) 4o6 3) �T.
Tank Capacities: 1)/dam% gal.
gal.
B. Pump Station (if required)
Pump make & model - / - s,f/ottach pump curve &
literature); system design requires
6 gpm atas -? feet of head.
High water alarm make & model
electrical work to be completed by
f/L.- - 4 Outside
installer electrician��
other Inside electrical work must be completed by
electrician.
C. Treatment System:
Trenches: s. f.
Mound _
A)'x t
Depth of rock below pipe
Rock bed dimensions
Drop Boxes
Sand bed dimensions 7E'X7P
Distribution Box
Pressure Dist. Pipe Diam. •, "
Maniford Pipe Diam. /_ J
D. Final Cover/Topsoil to be: borrowed from site
lAow location on site plan)
trucked in
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.
SignatureofApplicant: c l/ �z�f Date:
MPCA Certification No.:
Staff Review: Approval Denial
Reviewer: Date:
Reason for Denial:
CITY OF ORONO
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
JOB SITE ADDRESS:
SEPTIC SYSTE M PERWr APPLICATION
Occupancy Type: Residential Commercial Other
Permit Type: New or Replacement System, $100.00 A
Repair Exisdng System, $ 50.00
0. ' State surcharge added to above fees
*See fee schedule for non-residential permit fees
Owner's Name: Cz�h (��i/S C Pbone Number . 9 3 3 _ 7 -7/ 7
Mailing Address: City: Z1F
Contractor's Name: Lv , �ti -x�-� Phone Ntmiber: .I, 'v, y -
Mailing Address: %
DO NOT MAIL, PAYMENT WITH THIS APPLICATION
GENERAL i1114TRUC,�T ONS
1. Applications for septic system permits may be mailed or submitted in person at the City
Offices; however, permits will not be mailed out. The Permit must be picked up in
person at the City Offices and work must not begin unless the permit card is on the job
site.
2 Permits will be issued only to contractors holding a City of Orono Septic System
Installers License.
3. 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.
4. 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. inspection is required
C. Drainfield tench installation prior to covering. For mounds,
after rough -up but prior to sand placement (sand will be jar tested for silt content),
1W 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.
5. Individual holding MPCA Installer Certificate shall be present during inspections. A 24-
hour notice is required for all inspections.