HomeMy WebLinkAbout1995-09-08 Permit, Septic System #007325WY OF ORONO
2750 Kelley Parkway - P.O. Box 66
Crystal Bay, Minnesota 55323
(612) 473-7357
f WM ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
8514 WATER
Date Issued:
710 GANDZR RO
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P I N. 04-1 17-23-44-000-r-,
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NEW SEPTIC SYSTEM
Sewer 6 Water Permit Type NEW SEPTIC SYSTE
Sewer h Water Worl.-. Type RESIDENCE
F rNAATE '7-
1JI 00
330 O.A
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lARKS:
FU SUMMARY:
Base Fee •i
L,Urchoc rqe
---------
lotal Fee -$100.so 1
CONTRACTOR: - ;-,ir-plicant -
PATNODE EiR'l--lTHERS S 4 2 8 7'---: 9
2.' 73."'26 () 109TH AVE N
ROGER::.; MN SS374
f 61 '12) 428-739:3
011MR:
KYLE HUNT & PARTNERS
3:300 EDINSOROUGH WAY
EDINA MN SS4SS
M' 00IGNED HEREBY REQUESTS PERMISSAAIC-4
60 ANO AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL Cl
K INAES AND STATE CrF MINNESOTA BUILDING CODE RE651REPOTS.
APPMWIPEFUTEE SIGNATURE 1"Mogy SK"Tuf*
1 •1�
CITY OF ORONO SEPTIC SYSTEM PULNUT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay, iVIN 55323
JOB SITE ADDRESS: i C7 �a,�hZ1
C/
Occupancy Type: Residential Commercial Other
Permit Type: New or Replacement System, $100.00 L�
Repair Existing System, $ 50.00
(Tanks or Drainfield)
0.50 State surcharge added to above fees
*See fee schedule for non-residential permit fees
Owner's Name: � N l ac� of S Phone Number: 9C/ G — 3SS5-
Mailing Addrtm*e:-.,0V0
I-D ' City: �(Di.✓�!- Tom: ,�:5
Contractor's 617 tr Ito S Phone Number: q Z % - 7 3y 3
Mailing Address: 232oo /eicf — AUe- N City: 4*n5 Tp:_ZLS�
DO NOT MAEL PAYMENT WITH THIS APPLICATION
GENERAL INSTRUCTIONS
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 -,ork 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 accoruance 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.
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.
5. Individual holding MPCA Installer Certificate shall be present during inspections. A 24-
hour notice is required for all Inspections.
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.
v 2. I will be installing the following:
A. Taiacs: _recast Concrete _ Other Manufacturer L([u�S
Tank Capacities: 1) 10oo gal. 2) /vou gal. 3) ,aou gal.
B. Pump Station (if required)
Pump make & model t-AS LL d (attach pump curve &
literature); system design iequires gpm at / S feet of head.
High water alarm make & model Outside
electrical work to be completed by installer electrician
other Inside electrical work mus be completed by
electrician.
C. Treatment System:
Trenches: s. f. Mound
Depth of rock below pipe
Rock bed dimensions /0 '
Drop Boxes
Sand bed dimensions x'
Distribution Box
Pressure Dist. Pipe Diam.
Maniford Pipe Diam. Z. "
D. Final Cover/Topsoil to be:
borrowed from site
�ahow 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
reZulations of the State of Minnesota, and certifies that all statem'nts made on this application
are complete, true and correct
Signaturec)fApplicant: Date: -Sl9
-GW—
MPCA Certification No.: % ��
i
'aff Review: Approval _ Dermal c—
Reviewer: Z WE LDate:
Reason for Denial: