HomeMy WebLinkAbout1993-005655 - new septic _ �,,- ---�-� � PERMIT
CITY Q� ORONO PERMIT TYPE:
2750 f`elley Parkway • P.O. Box 815 =:;s�:f:;��:i�; :f ��:;"����
Orr�no, '�innesota 55356-0815 Permit Number: ._�SM��:;.�L
Date Issued:
(6�2) 4,�7357 '_s:�I�`''s_ ;'��t';
SITE ADDRESS:
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APPL CA PE M TEE SIGNATURE ISSUED BY:SIGNATURE
APPLZCT ^ION FOR SEPTIC SYSTEM PERMIT
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CITY OF ORONO
Box 66 (1335 So Brown Rd)
Crystal Bay, MN 55323
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General Instructions :
1. You may a�plv for septic system permits by mail or in person at the
City offices. However, permits will not be mailed out and must be
picked up 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 is avail.able on the job
site.
4 . Permits will be issued only to contractors holding a City of Orono
Septic System Installer ' s License.
5 . All work must be done in accordance with the approved septic syste�
design. Design reports are not considered approved unless accompar_�ed
by the "City of Orono Septic System Approval" cover sheet signed by
the City Inspector.
6 . The follawing inspections will be required for al.l septic systems :
a ) Pre-installation site inspection to include inspector, instaZler,
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) Fina1 inspection to verify proper final cover depths and to
verify that alI pump station (where required) components are
f unctional and comp iy with codes.
7. Individua7. hoiding MPCA Installer Certificate shall be present during
instal.Iation. 24-hour notice is required for all inspections.
t*************�***�t********************�************��t**********�*****�**
JOB SITE ADDRESS: 'I� S � —
Occupancy Type: Residential. � Commercial Other
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Owner' s Name: ��>��' -�-�-✓ Ylf�-{ / �-C n1 Phone: ��_5 -���
Mailing Address : City: Zip=
Septic Contractor' s Name: � � ��'? �X�- Bus. Phone: � �-.�C� �
Mailing Address : � � •� � �
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;EPTIC SYS�EM PERMIT APPLICATON - PAGE 2
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� Permit Type & Fees (check one)
�New Construction, Full System $I00 . 00 . . . . . . . . . . . . . .
Re�air 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 MAII� PAYMENT WITH �HIS APPLSCATION
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�OTE: Applicant must initial al l snaces. Fil I in aIl appropriate blanks,
check ail appropriate boxes . .
Initial
l. I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
2 . I wil.l be�snstalling the following:
A. Tanks: �' Precast Concrete Other Manufacturer
,-,
Tank Capacities : 1) C L`�Z% gal . 2 ) �L�Z���1 gal. 3 ) �yl��gal.
B. Pump Station (if required) D
Pump make & model 7 ���,�f/ (attach pump curve &
I.iterature) ; system design�ires �gpm at � feet
of head. High water alarm make & model ,� -r,.����-r ry�
Ou,�side electrical work to be completed by installer
✓electrician other Inside el.ectrica� work
must be completed by electrician.
'� ��� j,�/�d ��P���� ,�� c�
C. Treatment System: I' r'CS� �
Trenches: s.f. � ���
Depth of rock below pipe l Z " Rock bed dimensions 'x '
Drop Boxes - Sand bed dimensions 'x '
Distribution Box Pressure Dist. Pipe Diam.�
May�ifold Pipe Diam. Z/ "
D. Final Cover/Topsoil to be: � borrowed from site
(show Iocation on site plan)
trucked in
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'='he undersigned hereby applies to the City of Orono for issuance of a
septic system instailation permit, agrees to do alI 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 appl.ication
are comp lete, true and correct. �
� ; �
� � �/- �_S
Signature of Applicant: ��/"ZL��J �z�l'�'� Date: ��' � �
.dPCA Certification No. : � �
/O p��� J TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTIC� scHEou�Eo ib/-t-�/s3 � �Oa
PERMIT N0. �? `-" 5 � connP�ETEo >� 3 �'3t�
ADDRESS �� S
OWNER ✓ CONTR.�.���.��`
TELEPHONE NO. �7�I -S� 7 �
� DESCRIPTION�Z�,c.�r�J �Yl,�s
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 S 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTI('INS7AI i� 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC F L
� OWNER/CONTRACTOR TO MEET YOU: YES_NO M 11
� COMMENTS: "' �� `-�' —
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O ❑ CORRECT WORK,CALL FOR REINSPECTIOM TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. �- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContracto si .
Inspector. �'
White Copylinspector's Fiie Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED W ��� 3 ����
INSPECTION NOTICE � SCHEDULED l � - 3 • � a�
PERMIT NO. s(.�5 � COMPLETED �
ADDRESS � / � � �'1--
OWNER C NTR. ���i�.e,,�!/,c)Cc_c-�
TELEPHONE � 7 l - S C 7 �
� DESCRIPTION ,�')� C,� C�-�"-�
� 01 FOOTING 11 MECHANICALRI 16WELlTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI �SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBiNG FINAL 23
Q OWNERICONTRACTOR TO MEET YOU: ES_NO
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� COMMENTS: ������i�f� ��;�� /s/
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ^' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor s' e:
Inspector. ��
White Copyllnspector's File Canary CopylSite Notice
�f DATE TIME
CITY OF ORONO /r„✓�� CALLED IN
INSPECTION NOTICE ����� SCHEDULED
PERMIT NO. connP� rE� .� — ,��
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ADDRESS �
OWNER CONTR. ' ��('
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
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� 09 PLUMBING RI 15 SEPTI L. 22 FOLLOW-UP
J 10 PLUMBING FINAL � L
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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O C 1 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �- pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnedContractor o
Inspector.
White Copy/lnspector's File Canary Copy/Site Notice