HomeMy WebLinkAbout1995-007046 (sewer & water) PERIV�I
CITY OF ORONO . �
2750 Kelley Parkway- P.O. Box 66 / PERMIT TYPE:
Crystal Bay, Minnesota 55323 Permit Number: ' ,;, : =
(612)473-7357 Date Issued: "_�:��i�_��:�t�:
SITE ADDRESS:
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REMARKS:
FEE SUMMARY: i
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO ;�,� S� IC SYSTEM PERNIIT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
JOB SI'I'E ADDRESS: °�Oc�� �� S%D - D f}'D
Occupancy Type: Residential �_ ommercial Other
Permit Type: New or Replacement S tem, $100.00
Repair E�usting System, $ 50.00 � � U(1
(Tanks or Drain eld)
0.50 State surcharge ad ed to above fees
*See fee schedule for n n-residential permit fees
Owner's Name: /� f/ll�TU Phone Number: �L��—D D ���
Mailing Address: D (> S/17C 1�- City: . �p:
Contractor's Name: � � � � PhoneNumber: -S��
Mailing Address: yS�D ,C�/-�-r�TO�.> D� City:(���SXi�' tiP� ' .�
DO NOT MAIL PAYMENT WITH THIS APPLIC TION
GENERAI. INSTRUCTIONS
1. Applications for septic system permits may be ailed or submitted in person at the City
Offices; however, permits will not be mailed ut. The permit must be picked up in
person at the City Offices and work must not b gin unless the permit card is on the job
site.
2. Permits will be issued only to contractors h lding a City of Orono Septic System
Installers License.
3. All work must be done in accordance with the pproved septic system design. Design
reports are not considered approved unless acc mpanied by the "Ciry of Orono Septic
System Approval" cover sheet signed by the Ci Inspector.
4. The following inspections will be required for 11 septic systems:
A. Pre-installation site inspection to include ins ector, installer, and general contractor.
B. Tank installation prior to covering.
C. Drainfield trench installation prior to cove ' g. For mounds, inspection is required
after rough-up but prior to sand placement ( and will be jar tested for silt content),
and again during pressure distribution pipin installation in the rock bed.
D. Final inspection to verify proper final cover epths and to verify that all pump station
(where required) components are functional and comply with codes.
5. Individual holding MPCA Installer Certificate sh 11 be present during inspections: A 24-
hour notice is required for all inspections.
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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 instal�ing the following:
A. Tanks: X Precast Concrete Other Manufacturer
Tank Capacities: 1) �JG�b gal. 2) gal. 3) gal.
B. Pump Station (if required)
Pump make & model +�� ✓YlC.DO�A'l�-7� (attach pump curve &
literature); system design requires gpm at � feet of head.
High water alarm make & model 'I/Ef..- Outside
electrical work to be completed by x 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 /d 'x�'
Drop Boxes Sand bed dimensions y�'x��'
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Distribution Box Pressure Dist. Pipe Dia� ��
Maniford Pipe Diam. _�_"
D. Final Cover/Topsoil to be: borrowed from site
(show 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: � � �eU���� � Date: � � �� �J�
MPCA Certification No.: �/��
Staff Review: Approv � Denial
Reviewer: �� r� Date: C�`��
Reason for Denial•
DDATE TIME
CITY OF ORONO CALLED IN "' 7 ���
INSPECTION NOTICE i'�b�� SCHEDULED -��o � >� �- /% �
PERMIT NO. COMPLETED �� y�
ADDRESS `'�� �� a�
OWNER � �v��t.Z'`-.�--.v CONTR. .�e t�� � �
TELEPHONE NO. � �-s ���
� DESCRIPTION �t� �- %L.u-
ty� 01 FOOTING 11 MECHANICAL RI 18 �XCA /GRADWG/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKE HORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE EMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE I SPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PRO RESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COM LAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. � 22 FOL OW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HAR COVER REMOVAL
� 10 PLUMBING FINAL /G 36 FOU DATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:��YES_NO
� COMMENTS: � n�% � � / �
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d ;WORKSATISFACTORY:PROCEED ! PROJECT MPLETE
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� ❑ CORRECT WORK&PROCEED -- ISSUE CER IFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION EMPORARY
� BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONOITION WITHIN HOURS. -,, pHQTO TA EN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR '-: CITATION SSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspecti n 24 hours in advance.473-7357
OwnerlContractor on it .
Inspector. �� ��`� ���_�_�
White Copyllnspector's File Canary pylSite Notice