HomeMy WebLinkAbout2005-P08765 - repair septic ,. ,
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P08765
Crystal Bay, Minnesota 55323 Permit Type:
(952) 249-4600 Septic
Date Issued: 5/24/2005
SITE ADDRESS: 2635 Countryside Dr W Unit#
Long Lake,MN 55356
PID: 04-117-23-13-0007
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Se hc Permit Sub-type(s): Repair Septic System
Permit Type: p �
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Move Septic Tanks
FEE SUMMARY: Pernut Fee: $ 50.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 50.50
APPLICANT: Atco Utility Services OWNER: David&Teresa Gross
3660 County Rd/ 101 S 2635 Countryside Dr W
Minnetonka,MN 55391 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APP .ANT PERM[ E SI ATURE ISSUED BY SIGNA"CURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, ]-Assessing,(If Septic, 1-Septic) Page l
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CITY OF ORONO SEPTTC SYSTEM PERNIIT APPLICATION
Box 66 (2750 Kelley Parkway)
Crystal Bay,Mn 55323
,-,
JOB SITE ADDRESS at' ��3"s' -�t.�-r�u ���� �. l�-
Occupancy Type: Residential�_ Commercial Other
Permit Type: New or Replacement System $100.00
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: ���,Q�I�D ��-2.OSs Phone Number: �S a-'y�/� —7.3,j�
Mailing Address: �t b 3�- 'v. %�� -. City: U�c�,�r� Zip: 3�
Contractor's Name: ��� j,(;r`t J�v,c°�`s'Phone Number: ;•��.-�7�;--���j
Mailing Address: >'��G,�� �,. ,F'��, �r�� City: j�a,Kr�__ Zip: SS'3�/
*** DO NOT MAII. PAYMENT�'ITH THIS APPLICATION***
GENERAL INSTRUCTIONS
l. Applications for septic system permits may be mailed or submitted in person at the City
Off�ices; 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 Minnesota Pollution Control
A�ency(MPCA) 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.
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 stations
(where required) components are functional and comply with codes.
5. Individual holding MPCA Installers License shall be present during all inspections. A 24-houi-
notice is required for all inspections.
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NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate
boxes.
�� 1. I have received a copy of the system design including the City of Orono Septic
System Approval Cover Sheet.
�c/ 2. I will be installing the following:
A. Tanks: �_Precast Concrete Other Manufacturer
TankCapacities: 1) 15�'J gal. 2) 1J� gal 3) r.5�'J 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.
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
The undersigned hereby applies to the City of Orono for issuance of a septic system installation permit,
a�rees to do all work in strict accordance with 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.
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Signature of Applicant L.�'�"'� Date: ���`� �r
MPCA License No. � f-`�/��
---------------------------------------------------f---------------------------------------------------------------------
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Staff Review: Approval � Denial
Reviewer: W� Date• � '� �` � S
Reason for Denial:
OB/2Y/2004 O�:5J FA3 7634�3566 SP TESTING INC �02
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DATE . �� TIME
CITY OF ORONO CALLED IN S" '��
INSPECTION NOTICE SCHEDULED �- - *
PERMIT NO. /�0�71p�S COMPLETED � '" I- �� �I C��f1M
ADDRESS .�LP,�3� C'<���c�� �7-�a S'���2. !i� •
OWNER CONTR. -f c v
TELEPHONE NO. !S� ��� �o� L/ � ^ �C�/
� DESCRIPTION / ) e'/��`� `� �J--���or� _
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP �[ 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. �( /�..��`� 21 COMPLAINT
Q 07 DEMO-FINAL 15 SEPTIC INSTALL. � ��1� 22 FOLLOW-UP
T 09 PLUMBING Rt `�.3 SEP � � 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET U:� N
� COMMENTS: • � �
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W ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
p ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspectio 4 h urs-' vance. (952� 249-46��
OwnerlContractor on site: t- � --�
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Inspector.
White Copyllnspector's File Canary CopylSite Notice