HomeMy WebLinkAbout2004-P07448 - new septic r� ,
` �' PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po�44g
Crystal Bay, Minnesota 55323 Permit Type: septi�
(952) 249-4600 Date Issued: s�3�2o04
SITE ADDRESS: 509 Ferndale Rd N
Wayzata,MN 55391
PID: 36-118-23-13-0011
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Septic Permit Sub-type(s): New Septic System
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 100.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 100.50
APPLICANT: Swedlund Septic(See Comn7ents) OWNER: David&Keiko Thurston
930 Deer Creek Parkway 509 Ferndale Rd N
Belle Plaine,MN 56011 Wayzata,MN 55391
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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APPLICANT PGRMITEE SIGNATURG ISSUEU{3Y SIGNA'I'URE
Copies: 1-File(Si�nitures Requrred), 1-Applicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1
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' CLERN# 0"s TRANSY tc`'93b
�� � SEPTIC SYSTEM APPROVAL
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C ITY of ORONO
�',, � Municipal Offices
�.� .�G Street Address: Mailing Address:
`9k'EggOg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner Dave Thurston Phone (Home) 404-1357 (Work)
Address 509 Ferndale Rd N City Orono State MN Zip
Site Evaluator Swedlund State License # 398 Phone# 952-657-1034
Type of Establishment: Single Family X Multi Family
Commercial Est. Gallons Per Day 600
No. Potential Bedrooms 4 Slope: 5-7%
Depth of Sand: Upslope: Downslope: Soil Sizing Factor 1.67
Perc Rates P-1 ll P-2 13 P-3 16 P-4 P-6 P-7
Restricting Layer Depth B-1 54" B-2 54" B-3 >72" B-4_ B-5 B-6 _
Type of Treatment System:
Standard X Alternative Other Performance
Pressurized Mound System At-Grade System
Gravity Trenches System Pressurized Trench System
Gravity Trenches W/ Lift X Pressurized Bed System
Holding Tank W/ Alarm
Septic Tank Size 1000 # of Tanks 2 Lift Tank Size 1000
Pump Brand GPM tbd Head 12
Treatment System:
Minimum 1002 Square Feet with 12 inches of rock below pipe
Bed Mound Treatment Area
THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. A
permit must be issued to a licensed septic contractor prior to installation.
NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the
inspector (952-249-4600) Call for inspection 24 hours in advance.
ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and
fencing must remain in place until final site grading. Approval to pour footings will not be granted
until the Inspections Department has verified the primary and alternate sites are protected.
NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20'of tested draintield sites ever.
ACCEPTED X DENIED By the City of Orono subject to existing regulations and the
following conditions:
1) Existing system to be used only for filter and sump pump water.
2) Alarm must be placed inside house.
3) Keep all water softner and iron filter discharge out of septic system.
4) Four trenches to be 50 feet from well.
By: '���� ���-'-�� �- �� �' � ��
Matt Bolterman, On-Site Systems Manager Date
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
� ' � ` � Swedlund
Se tic
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S ervice
�erc Test R��'�,��'�
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Soil Boring C�TYOFORO
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�esign
❑ Installation Estimate
Prepared For:
1� �4 tJ i�d- /��/S o %fi��/Z.S�`b•J
S�'o9 �".�z��1 c�,q.G�' ,�� �J
C��oivo SS�9 /
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Site Address:
�r9✓yJ E
�"ITY OF ORONO
SEPTiC�ERM T I,qIV RBVIEq/
fi•cnt:�,T.,., v)���:�
DATE �.-Z, p-p L pERMIT NO,
� APPROVEp AS SC9M(TTED
APPROVEb W(TH CORRECTJ011TS As Np�II
NOT APPROVED-CpRg�r 4 RE8U8M17'
These eommeqts ar�for your�fo�� �Mak s��
in fuU oompiirp�with di uppficabk teptfp and mnin8�.
Requircments fncluding ttems not epeci�cal1y AoteJ!i t1►N ro
I KEEP?}ft3 PLAN S&T OAi 5lTE A1'ALL TlM6i
S�a�� �ertifiec�
;
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lSwedlund Septic Service • 9520 Laketown Road • Chaska, MN 55318 • 442-5855
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� Swedlund
Se tic
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Service
SEPTIC SYSTEM DESIGN
Date ��/S=63 ��'�"�11t�(�y�
Owner/Builder l i 2S'7`�� ��
Address s�� ,�t.v�A�E .�a� � Q�dwJ� � �rH�S�St��r
Site Address ��A�'►� �
Home Phone���f����f 7 Work Phone Pager/Cell
The following information has been compiled for a single family home:
Bedrooms '� _ GPD �_ Garbage Disposal � Lift Pump in Basement�
Septic Tank Capacity ZOoo Pump Tank Capacity /Oo0
System Type: Mound Trench �
Distribution: Gravity �_ Pressure Land Slopes" 1�
i
Depth to Restricted Layer S�L Soil Sizing Factor � Perc Rate /�" "" �7
Trench System: Drainfield Size/Sq. Ft. D Lineal Ft. .�
S62 Number of Laterals Rock (Tons)
i i
Rock Width Max Trench Depth ,z Width
C�•o�,�E�. SG Sec�,s...r -. 8 .�'.,�d /�,�•o�Es
Mound System: Rock Bed Sand Layer
Upslope Downslope Sideslope
Sand Depth Topsoil on Site Trucked in
Sand (Tons) Rock (Tons) Topsoil (Tons)
Pump Manufacturer: (�ou f c�
Requirements: GPM Head
i�
Force Main Length Diameter ,Z
Number of Laterals � Length
Swedlund Septic Service • 7775 TacomaAvenue • Mayer, MN 55360 • (952) 657-1034
State Certifed Lic.#398��
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. _ ,iNGROUND SEWAGE TREATMENT SYSTEM WORKSHEET
� FLOW
Esumaicd Sewngc Flou-s in(lallnn.a per d;ry �
A. Estunated ��� gpd c ��
measured X = gpd Numbcr Clac�I Clvu[I Cl:�cc I➢ Clacr
of N
B. Septic tank volume ��00 gallons �"""�
z � xn ' �zs ! -isui �,x ,
3 45U 30U ' .IR ofthc
4 H70 l75 :S6 ��i�
SOILS (Site evaluation dat ) s �so aso �v4
� 6 4(() S25 3}2 T L I
C. Depth to restricting layer = �" L feet , �aw � «x� , s,o „';;, �
D. Maximum depth of system C -3 ft= x. feet I � '``x' ' �'` ' "'� '� 1°
E. Texture �.�os�+'►1, Percolation rate�MPI � I i____i"''�°�-'
F. SSF /� sq ft/gpd
Se tic Tank Ca acities in allons
G. Slope L_� °�o Liquid capacity
Number of Minimum Liquid Liquid capacity with with disposal&
Bedrooms Capacity garbage disposal lift inside
TRENCH BOTTOM AREA z o�iess �so i i2s isuo
H. For trenches with 6 ches of rock below the pipe: �o�a i000 isoo 2000
A x F =��x �. = QI sq ft of bottom area s or 6 isoo 2250 3000
7.8 or 9 2000 3000 a000
I. For trenches with 12 inches of rock below the pipe:
A x F x 0.8 = x X�.g = SCl ft Of bOttOI7l dlEa Soil Characteristics and Soil sizing factors
J. FOI'tt'enC�IES wltrl 1� 171Ct12S Of COCLC belOw t�"le�Jipe: (SSF)forSewage 13'separation)
Pertolation rale Sc�u.�re leet/
A x F x 0.66— x x 0.66 = sq ft of bottom area (minutes/inch) sod texture Rallon/dav
K. For trenches with 24 inches of rock below the pipe: F�s�e.�n��o,• cor�sesr�� --
0-1 to S Med�um Sand 087
Loamv Srnd
A x F x 0.6= x x 0.6 = sq ft of bottom area o���s Fine Sand" 1 67
5 to 15 Sandv Loam 1 27
16 to 30 Loam 1 69
SEEPAGE BED BOTTOM AREA 3����as s�i�s�o�m zc�
�46 to 60 Clav Loam ICU '_.'_0
L. For gravity beds with 6 or 12 inches of rock below the pipe; Ss�ia�c�
1.5 x A x F = 1.5 x x = sq ft of bottom area '�O1Ne"nT"60-• s��d��c�r�
For pressure beds with 6 or 12 inches of rock below the pipe; S°'�c'��
'Soil too cwrse for sewage[reatmenl.
A x F = x = sq ft of bottom area Use systems for rapidlype rmeable sods
"Sod having 50°i�or more Fine sand+verv fine sand
"5oil with too high r percenlrge o(clav(or
ROCK VOLUME,WEIGHT installationofastandardinRroundrvslem
M. Rock depth below distribution pipe plus 0.5 foot times bottom area: so�i charaae�sh�5 ana so�i 5+���g�a�con
M =Rock depth +6 inches x Area (H,I,J,L,K) (SSF)for Gravelless Pipe
percolation ratr squAre leeii
( +0.5 ft� x = Cu ft �m��wesi���n� saa�ex�„re R�u��iary
Fas[er than 0.1' Coarse Sand
N. Volume in cubic yards = ��olume in cu ft divided by 27 0,�os MediumSand oz�
Loam v S�nd
M=27= cu yds_=27 = cu yds 0 1 to 5 Fine Sand" 0 b
6 to 15 Sandy Loam 0.�42
O. Weight of rock in tons = cubic yards times 1.4 ,b�o�o Loam osh
31 to 45 Silt Loam O.h;
N x 1.4 = tons x 1.4 = tons s�"
16 10 fi0 Clay Loam(Cl.) 0 7a
Sandy Cl
Sihv CL
DISTRIBUTION `�°,ver1h�a60•• s��d;�c���
(Check one based on slope) Bed (<6%slope) s'"�c���
5oil too cwrse(or sewaRe IreatmeM.
Trenches ✓Drop boxes (any slope) Distribution box (< 3%) Usesvstems(orrapidf,�ertneablesoils
"Soil hae��nR 50%or more ine sand.verv(ine sand.
"5oil w�ith too high a pertentage o(dav(or
mstalla[ion of a riandard inRround svstem.
SYSTEM LENGTH
P. Select width=�__ft
Q. Divide bottom area by width: (H,I,J, or K) — P = lineal feet �`"1e"''e`�n"`
a. o'ea•po�ppapa•a�o f 2'R�ckCo.'
— — lineal feet � '�°° - `1
Gravelless Pipe (10") (Flow x Gravelless SSF) �a°=� �°'a'op°. I' °ist°�Pe
�D,�de eD, D,e I
x = lineal feet °�° �°"��°'� ' -
eD,: odeao'0'oao
Chamber(H,I J K [based on hieght of Chamber] —width of chamber) °',��'�°;�°"o'o�� �
���=�=�lineal feet �;p;' o0.o�:aa'�Dc��0.��1D e 6-24"Rock
p0.OQ��DeD, �oqop0�a 3/4-21/2,.
4°�e°oD,�Do eeD,��oD�eD�
LAWN AREA e��a� eeD,�D�o�d� ,�o„
e.��,rD��D,o 0��<0 o"Oa
R. Select trench spacing,center to center= 7 feet °���°�"°��°�°�_����'�'
S. Mul iply trench s acing by lineal feet R x Q= sq ft of lawn area '"'" "'d`h
��x��i�sq ft 3. Show location of house,garage, driveway,and all
other improvements, existing or proposed.
LAYOUT 4. Show location and layout of sewage treatment
1. Select an appropriate scale;one square = feet. system.
2. Show pertinent property boundaries,rights-of-way, 5. Show location of water supply well.
6. Dunension all elevations, setbacks and separation
easements.
distances.
9
PUMP SELECTION PROCEDURE
A. Determine pump capacity:
Gravity Distribution
1. Minimum suggested ' g m _
2. Maximum suggested 5 4 Pm Perforation Discharges in GPM
Pressure Distibution Head Perforation diameter
feet inches
3. a. Select number of perforated laterals �/s2 i/4
b. Select perforation spacing= feet. 1.oa o.56 0.74
c. Subtract 2 ft. from the rock layer length. �.5 0.69 0.90
RocJc layer IengN
-2 ft. = feet. 2.ob o.so 1.04
d. Determine the number of spaces between perforations. a Use�.o foot single homes.
Length perf.spacing= ft.= ft. = spaces b Use z.o feet for anything else.
e. spaces+1 = perforations/lateral
f. Multiply perforations per lateral by number of laterals to
get total number of perforations. ��� x � 5-��= perforations.
S. pT x�,m,�= gpm.
SELECTED PUMP CAPACI�-���gPm
B.Determine head requirements:
1. Elevation difference between pump and point of discharge.
_�feet
2. If pumping to a pressure distribution system,five feet for pressure s�''�'""��SYs�e»'
required at manifold if gravity system,zero. °�°="�'°�
„B-- feet T°�'P'�'�'gm
3. Fnction loss
a. Enter friction loss table with gpm and pipe diameter. ,,,le ElevationDifference
Read friction loss in feet per 100 Eeet from table(F-14). P'� •
------- -- -
F.L. - 2 ft./100 ft of pipe
_..- -
b. Detemune total pipe length from pump to discharge �'-�------��--�--�----�-�-"�'�-----�
point. Estimate by adding 25 percent to pipe length for fitting
loss,or use a fitting loss chazt(F-15 feet).
Equivalent pipe length-125 times i e length=
��X 125=��feet Friction Loss in Plastic Pipe
c. Calculate total friction loss by multiplying
friction loss in ft/100 ft b equiva e pipe length Nominal
,a7� �[3' �_ pipe dia.
Total friction loss= �.,�.L x 100= � feet
F1ow Rate
4. Total head required is the sum of elevation difference, �m 1.5" 2" 3"
special head requirements,and total friction loss.
20 2.47 0.73 0.11
�_+ d + .� 25 3.73 1.11 0.16
(1) (2) (3c) 30 5.23 1.55 0.23
35 6.96 2.06 0.30
40 8.91 2 64 0.39
TOTAL HEAD �+Z feet 45 11.07 � 0.48
50 13.46 3.99 0.58
55 4.76 0.70
C. Pump selection bo 5.bo o.s2
65 6.48 0.95
70 7.44 1.09
� l. A pump must be selected to deliver at least
gpm (Step A) with at least �� feet of total head (Step B).
Sizing of Pump Station
]. Dctcrminc Si�rfacc Arca T
Rcctangle= Area= L x W wid�h
x = square feet Lcn �h 1
6
Circle= Arca =n x(Radius)2
3.14 x x = square feet K�����
Other=Get Surface Area from Manufacturer rz=3.ta
square feet
2. Calculate Gallons Pcr lnch
There are 7.5 gallons per cubic foot of volume,therefore you must multipiy the area
times the conversion factor and divide by 12 inches per foot to calculate gallons per inch
Arca x 7.5 gpft 3+12 inchs per foot
_ x 7.5+12 =�gallons/inch
3. Calculatc Gallons to Cover Pump(with 2 inchcs of watcr covcring pump) Estimata!Scwage Flows in Gallons per day
(Hcight(in)+2 inches) x gallons/inch(#2) �g��
(��+_�)x��= ZZ gallons o[ r Type I Typc[t Typc 11[ Typc
I3cdrooms 1 V
4. Calculate Total Pumpout Volume 2 300 225 180
a. To maximize pump lifc select sump sizc for 4 to 5 pump operations per day. 3 a50 300 2]8 ��
fap�_�pd+4 = ��p gallons per dosc 4 600 375 256 °f`�`
b. Calculate drainback
5 750 45U 294 Valn�
6 900 525 332 �Yr��.
l. Determine total pipe length, 70 feet. 7 1050 600 370 ""`
2. Detcrmine liquid volume of pipe,/���gallons per 1(H)fect. 8 1200 675 408 tolomns
3. Multi ly length b volume: Drainback quantity=
�O feet x .+� gallons/l(�ft. __�gallons.
Vi di�mttcr inchcc Gxllins r 100(cci
c. Total pump out volume equals dose volume+drainback 1 4.4
/Sd gallons per dosc+��galioi�s=_��_gallons 1.25 7.77
l.S 10.58
5. Calculate Volume for Alarm(typicaliy 2 to 3 inchcs) 2 17.43
Depth �n)x gallons/inch(#2)= 2.5 24.87
�3 x Z =��gallons 3 38.4
4 66.1
6. Calculate Reserve Capacity(75% the daily flc�w)
Daily flow(see page 7)x.75=
DO x.75= o gallons
Rcservc Capacity
7. Calculate total gallons
�allons over pump+gallons pumpout-��;�ilc�ns alarm +gallons reserve capcity
#3+ #i4 c+tt S +#6 Alarm
�iz + lL2 +� + S =�Qgallocis
Pump On
S. Total Dcpth (Total gallon dividcd by�allc�n per inch)
Total Gallon (it7)+�allo /in h (tt2)
g�p +� =y���nches To�il Pumpo�t Volumc
Pump OfF
Pump Hcight
9. F7oat Scparation Distancc(equal total pumpout voluinc)
Tc�tal pumpout volumc(#4c)+�allons/inch(#t2)
�4�_��___�inches
. ,
LOGS OF SOIL BORINGS
Location or Project .�-O 9 /�.�,Zi�.!dla,4E ,�'c� A.� p ea.v0
Borings made by SWEDLUND Date /�-/�03
Classification System: ❑AASHO 0 USDA-SCS ❑ Unified ❑Other
Auger used (check two): 0 Hand ❑ or Power; ❑ Flight C�or Bucket; ❑ Other
Depth, Boring Number �/ Depth, Boring Number .BL
in feet Surface Elevation in feet Surface Elevation
p ,!'!�t/..s.6E/� 0 .v S /
a�i t ,,,� 3�3 °�8 ,C 3 �3
i - �3/ S/ i - �
2 - Z� ��'�++-1 8 2 _ � ��4� �/�
�
zs
3 - / s;,��, -��-� �/8 3 - 3 y ��.��� �
�B /s- sA.�� /�
4 - y 4 - y� SA--d /G•�vE� .1
9 S ;l �j 5.�.....d -�
�.� sG
5 - ¢z �/�j 5 �i,� SAr..c�
�z s- '�
6 - 6 -
/r�o�E � .S"'� � hlo7�� c� �� /
� - G�z �2�► � G�L Ga.•�
r
8 _ 8 _
9 - 9 -
10 - 10 -
End of boring at � feet. End of boring at � feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
� Not present in boring hole. � Not present in boring hole.
Mottled Soil: �j Mottled Soil: �
❑ Observed at -S Z feet of depth. ❑ Observed at -s/Z feet of depth.
❑ Not present in boring hole. ❑ Not present in boring hole.
LOGS OF SOIL BORINGS
Location or Project -�O 9 �,Q�,•�,,�,`C .�c� .0 d�a�vt9
Borings made by SWEDLUND Date ///.S=03
Classification System: ❑AASHO Q USDA-SCS ❑ Unified ❑ Other
Auger used (check two): 0 Hand ❑ or Power; ❑ Flight C� or Bucket; ❑ Other
Depth, Boring Number 3 Depth, Boring Number
in feet Surface Elevation in feet Surface Elevation
0 0
a�7 .L�.w `�/.3
1 — �j�O �i�s,�+�✓e� [s�2�1J�� '�� 1 —
r
2 — Z� 2 —
_ � �,� ,� .�i►...al "r,/G -
3 �3 3
4 — y�// ��''�� `�,/�i 4 —
�Gc
5 - 5 -
6 - �Z v.�RvE� 6 —
7 — 7 —
8 — 8 —
9 — 9 —
10 — 10 —
End of boring at feet. End of boring at feet.
Standing water table: Standing water table:
❑ Present at feet of depth, ❑ Present at feet of depth,
hours after boring. hours after boring.
� Not present in boring hole. ❑ Not present in boring hole.
Mottled Soil: Mottled Soil:
❑ Observed at feet of depth. ❑ Observed at feet of depth.
� Not present in boring hole. ❑ Not present in boring hole.
D`ate� //-/�-o� PERC TEST BY SWEDLUND SEPTIC
.
Location .S�o� �,r,✓�q L� ,�c� 0� Hole # � Depth 2
Soil Depth D � /2 Texture �a-*�►�
Depth of Initial �
/3 '2 �. ,Lo�•�►y�✓ Water Filling /
Perc Test starting Time and Date: Time �. P�'vi Date 1�- �-S
Time Intervals Drop in Inches Perc Rate
�_ 2 o d ...-. / '� //
zo_ �r 4o ir 3 ,/
40_ ,z �� '/ ii
Date /l-�g-v3 PERC TEST BY SWEDLUND SEPTIC
Location s•9�-»� Hole # � Depth -� �
Soil Depth b-► q Texture ��sf�7
Depth of Initial ,
�d '2`� s• .��-�-� Water Filling /
Perc Test starting Time and Date: Time /. ��1 Date / 1��-i
Time Intervals Drop in Inches Perc Rate
_ � zo o .w / � �3
�m _ 9a '' %z. 3
9m _ '� '/ /
Date //-��-e� PERC TEST BY SWEDLUND SEPTIC
Location os�9�� Hole # -� Depth a �
Soil Depth b -/b Texture ��^-�
Depth of Initial ,
//-Z� s - _ Water Filling _�
Perc Test starting Time and Date: Time / �''ri Date //-/S"
Time Intervals Drop in Inches Perc Rate
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CITY OF ORONO SEP'TIC SYST'ENI PERIVIIT APPLIC�iTION
Bog 66 (2750 Kelley Parkway)
Crystal Bay, Mn 55323
JOB SITE ADDRESS � _' �� %�%' d�'lU-��r-3,LC. �Jt�(� ,/V
Occupancy Type: Residential X Commercial Other
Permit Type: Ne�v 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: ��r�V�1���� ! r��` l-�� �1�5 i��\l Phone Number:
Mailing Address: City: Zip:
Contractor's Name: �.;:E=7-�� c� r�, 7 E:l�i%C_ Phone Number: ,�' �� �-''�//
Nlailing Address: ��/-�G D�=�/�- �_��c���� /�1��� �� City: /��,�.,CL��� Zip: h���i/
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*** DO NOT NIAIL PAYMENT"'TTH 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 work must not begin unless the permit cazd is on the job site.
2. Permits will be issued only to contractors holding a Minnesota Pollution Control
Ajency(MPCA) Septic System Installers License.
3. All work must be done in accordance with the approved septic system desijn. 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
roujh 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�IPCAInstallers License shall be present during all inspections. A 24-hour
notice is required for all inspections.
. . 1
,. 1
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.
2. I will be installing the following:
A Tanks: h Precast Concrete Other Manufacturer
Tank Capacities: 1) ;`% ,'%.� gal. 2) / ;;<<� gal 3) � gal
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, :.
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 ,( /';;'�;�, �}�r� �'i)'� . 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 �z-ork in strict accordance with ordinances of the City and the regulations of the State
of Nlinnesota,and certifies that all statements made on this application are complete,true and correct.
� _� i� � � �
SignatureofApplicant ��� � �, �� �� < < ; � �� � Date: > � C�`�
MPCA License tiTa �(/�
----------------------------------------------------------------------------------------------------------------------
Staff Revie�v: Approval Denial
Reviewer: Date: �
Reason for Denial:
. /
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO,JI���t� p' SCHEDULED
PERMIT NO. � / o COMPLETED �-S`(a�"'f
ADDRESS `��`� F{���'�� w �-'
OWNER CONTR. S w t��v.,r.
TELEPHONE NO.
� DESCRIPTION SC�' t `
� 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI �SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU�YES_NO
� COMMENTS:
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W� O WORKSATISFACTORY:PROCEED 1�ROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION RE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. �A1`r`�-(.� , ,
White Copylinspector's File Canary CopylSfte Notice