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Home My WebLink About2002-P05894 - septic t - . CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Posg94 Crystal Bay, Minnesota 55323 Permit Type: septi� (952) 249-4600 Date Issued: 12�9i2oo2 SITE ADDRESS: 629 Ferndale Rd N Wayzata,MN 55391 PID: 36-118-23-11-0031 DESCRIPTION: Proposed Use: Residential Pernut Class: General Permit Type: Septic Permit Sub-type(s): Repair Septic System DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: � 50.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 50.50 APPLICANT: Atco Utility Services OWNER: Kirt&Margaret Mostrom 3660 County Rd/ 101 S 629 Ferndale Rd N Minnetonka,MN 55391 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � �'` � �� :'?7 � � - ��- � -�!�/G'-�'I ��iG/JZ. ,- ) APPLICANT P ITEE SIGNATURF., ISSUED BY SIGNATURE Copies: 1-File(Si�nitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 i � � CITY OF ORONO SEPTTC SYSTENI PERMTT APPLICATION Box 66 (2750 Kelley Parkway) Crystal Bay,Mn 55323 _ JOB SITE ADDRESS �� / � `J� l-"L'"2ti/D,��C ��"� Occupancy Type: Residential /� Commercial Other Permit Type: New or Replacement System $100.00 Repair Existing System $ 50.00 SQ °—' (Tanks or Drainfield) $0.50 State surchai•ge added to above fees * See fee schedule for non-residential permit fees � -- Owner's Name:��2� � o:��2v M Phone Number: � `7S a �8a 7- ��j`� Mailing Address: �9 /�• F%��.�4��= G�. City: �r.Q� Zip: s3 3g/ Contractor's Name: GQ ,' � , Sen�r c� Phone Number: is�- Y'7�- ��y� Nlailing Address: .�G�<J �� • /o/ S. City: �''�r/s�- Zip: �.3F3�/ *** DO NOT MAIL PAYMENT`ti'ITH THIS APPLICATION*** GENERAL INSTRUCTIONS 1. Applications for septic system permits may be mailed or submitted in person at the City Offices; howe�-er, 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«�ork must be done in accordance with the approved septic system design. Design reports ar� not considered approved unless accompanied by the "City of Orono Septic System Ap�roval" 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��CAInstallers License shall be present during all inspections. A 24-hour notice is required for all inspections. K i NOTE: Applicant must initial all spaces. Fill in all appropriate blanks and check all appropriate boxes. l. 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 �C�L�s Tank Capacities: 1) %C�� gal. 2)�gal 3) /�SO 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, agrees 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. .� SignatureofApplicant ��_�,.�_ Date: /� % O�2- NLPCA License No. / ------------------------------------------------------------------------------------------------------------------------- StaffRevie�v: Approval /�1' Denial � Reviewer: ��"�' �,"l �.�'�''�1��`"�.� Date: /�-�-D7-. Reason for Denial: ,� DATE TIM CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED a - L. 'UU � PERMIT N0.�S�P'`7y COMPLETED '� �d- 't=G ADDRESS ft��'��(' �-Erll�� - � OWNER CONTR. �TC-Ca TELEPHONE NO. �,� �7.� 7o�y� � DESCRIPTION ��-�'�"�-� � 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 OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL ]5_SE�I@-1 22 FOLLOW-UP ? 09 PLUMBING RI �23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL ` � /�' 36 FOUNDATION/REMOVAL � OWNERICONTRACTOH TO M Ef YOU:�fES_NO � COMMENTS: ` �� 5 � �trn �� c�- �-��e�� ,1 a !' j�.sc� -� l �Oc�-� Ic� GG� ��1 S ��^� � �- S� �� S 0 � — 6�C�� -.�;� v r� �Ic;� ,� � ��-n o � � --�� -j-�,� � C i��`CC �' � (�rk,c W � Q � 2 W � W � � � ,�NORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W�❑CORRECT WORK&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 REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on sit . �� Inspector. �� White Copy/lnspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. =S COMPLETED � 0`- � ADDRESS ��C� 1" . FPtc��2 �� OWNER CONTR. �� C_ �� TELEPHONE NO. � DESCRIPTION � ��''��- �- 1 � �� `� � Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSUl11TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP � 09 PLUMBING RI 23 PTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � � � ��a��f M J �- C��:�� `'�Si��r-� �^.. -.�,.� r.�� t � O � �' { �,l U C� � O � �i M /\ �� W 1 QC/ � � ;(�`� ` � � � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALlTO ARRANGE ACCESS. Call forthe next inspection 24 hours' advance. (g52) 249-46�� OwnerlCon tor on site: � � �� Inspector. � " `��'� �_ White Copyllnspector's File Canary CopylSite Notice