HomeMy WebLinkAbout1992-004508 (Septic) 9' ' -
PERIi�IIT �
CaTY �F OROfVO PERMIT TYPE:
' 1335 Brown Rd. South • P.O. Box 66 -' ' °� WATE�,
Permit Number: t�� _�t�;
Crystal Bay, Minnesota 55323 Date Issued: tf7f:�11'�:�
(612) 473-7357
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: — �1��la.c�nt — OWNER:
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APPLICA /P MITEE SIGNATURE ISSUED BY.SIGNATURE
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APPLICATION FOR SEPTIC SYSTEM PERlSIT
CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay, 1��IIJ 55323
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General Instructions:
1. You may apply for septic system permits by mail or in person at the
City offices. However, permits will not be �ailed out and mnst be
picked np in person at the City offices.
2. Permits are not valid until you receive a permit card.
3. Work must not begin unless the permit card i� available on the job
site.
4. Permits will be issued only to contractors holding a City of Orono
Septic System Installer' s License.
5. AI1 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 instal lation 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
instal lation. 24-hour notice is required for alI inspections.
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Jos si� Ann�ss: 2 3 g'd �� ,'���o,,� f.cJa�i
Occupancy Type: Residential� Commercial Other
Owner's Name: �o�� �/���7Co� Phone: �/`�_�--�f��Z
Mailing Address: 2 3 ���6i�,.,�ia� �iZ✓�ci City: D�d��� Zip:
Septic Contractor's Name: �//,v�, S S,�y,�aG�S �a-�c, Bus. Phone: �/7�-y3aa
Mailing Address: 36�p ,�i�iiv, , /o/Sd. City: (,(,/ Zip: S.S3�/
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SEPTIC SYSTEM PSRMIT APPLICATON - PAGE 2
Permit �pe � Fees (check one)
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
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NOTE: Applicant must initial all spaces. Fill in aIl appropriate blanks,
check all appropriate boxes.
Initial �-�t��v� �o� � �'v�e�,�� G� p✓��h�F� ��Q
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: Precast Concrete Other Manufacturer
Tank Capacities: 1) gal. 2) gal. 3 ) gal.
B. Pump Station (if required)
Pump make & model (attach pump curve &
literature); system design requires gpm at feet
of head. High water alarm make & model .
Outside electrical work to be completed by _installer
electrician other . Inside electrical work
must be completed by electrician.
C. Treatment System:
Trenches: s.f. Mound
Depth of rock below pipe " Rock bed dimensions 'x '
Drop Boxes Sand bed dimensions 'x '
Distribution Box Pressure Dist. Pipe Diam. "
Manifold Pipe Diam. "
D. Final Cover/Topsoil to be: borrowed from site
(show location on site plan)
trucked in
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The undersigned hereby applies to the City of Orono f or 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: � Date: ��1-��
MPCA Certification No. : �
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC � SCHEDULED �"a� �'�
PERMIT NO. �� COMPLETED
ADDRESS S�
OWNER CO TR. �U�l�►�
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 IXCAVIGRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK•UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK•UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 1 NSTAL 22 FOLLOW-UP
J 10 PLUMBING FINAL 23
Q OWNER/CONTRACTOR TO MEET YOU: YES_NO
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Qy/��dORK SATISFACTORY:PROCEED �PROJECT COMPLETE
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W �CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RERIRN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract s' e:
Inspector.
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