HomeMy WebLinkAbout1992-004186 - repair septic system PERMIT
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CIT� OF ORONO PERMIT TYPE: _- � -�- y ���� --�_
• 1335 Brown Rd. South • P.O. Box 66 �-��-�''�-�,-r:� ''�'�i� ��'
Permit Number: �_��_��i=�,��
Crystal Bay, Minnesota 55323 Date Issued: ��"` +��
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(612) 473-7357 �
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APPLICANT P TEE SIGNATURE � ISSUED BN:SIGNATURE �--
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APPLICATIOl� FOR S$PTIC SYSTEM PERIKIT
CITY OF OR�NO
Box 66 (13�5 So Brown Rd)
Crystal Ba�, 1�IId 55323
******:*:* �***�*#��*#*:#�**�r�****��****�r:�***:��*�#�:��t*** *:�****#*�***:
General In�tructions:
1. You m�y apply for septic system permits by mail or i person at the
City �ffices. However, permits will not be mailed t and must be
pickec� np in person at the City offices.
2. Permit{s are not valid until you receive a permit card.
3. Work must not begin unless the permit card is availa le on the job
site. ;
4. Permii�s will be issued only to contractors holding a City of Orono
Septid System Installer' s License.
5. All w�rk must be done in accordance with the approved septic system
desig '. Design reports are not considered approved unl ss accompanied
by th "City of Orono Septic System Approval" cover s set signed by
the C'ty Inspector.
6. The fa,llowing inspections will be required for all s�pt' c systems:
a) Pjre-installation site inspection to include inspec or, installer,
a d general contractor.
b) T nk installation prior to covering.
c) D ainfield trench installation prior to coverin . For mounds,
i spection is required after rough-up but prior to sand placement
( and will be jar tested for silt content) , and again during
p essure distribution piping instal lation in the r ck bed.
d) Final inspection to verify proper final cover depths and ta
v�erify that all pump station (where required) c�mponents are
f�unctional and comply with codes.
7. Indivi ual holding MPCA Installer Certificate shall be resent during
instal ation. 24-hour notice is required for all inspec ions.
#*******��r* ***:********�**:*********�*****�*:�*******��**:** *�**:********
JOB SITE AD�R$SS: ,
Occupancy T�pe: Residential� Commercial Other
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Owner' s Nam : Phonea �
Mailing Add ess: �ity: Zip:
septi c Cont actor' s Name:_ ��/1,rq� �, -���spy� �. sus. hone: �, /-g/�1
Mailing Add ess: /�,12 ,� ,�pr o�� City: y10 Zip.: �S3r�g
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SRPTIC SYSTEM PERlsIT APPLICATON - PAG$ 2
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Permit Type & Fees (check one)
New Construction, Full System $100. 00 . . . . . . . . . . . . . .
�_ Repair or Replace Existing System $50.00. . . . . . . . . . . . .
$0.50 State surcharge added to above permit fees
SEE FEE SCHEDt�LE FOR NON-RESIDENTIAL PERMIT FEES
DO NOT MAIL PAYMBNT WITS THIS APPLICATION
****��*****�*�*#**�**��:******�*****���*��*********����*:******�*�******�**
NOT$: Applicant must initial all spaces. Fill in al 1 appropriate hlanks,
check all appropriate boxes.
Initial
1. I have received a copy of the system design including the
City of Orono Septic System Approval Cover Sheet.
2. I will b installing the following:
A. Tanks: � Precast Concrete Other Manufacturer
Tank Capacities: 1) l�gal. 2 ) �gal. 3 ) 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 . Inside electrical work
must be completed by electrician.
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
#�*�***:*�:*****�*::*:���:�*:*�****�*****�***::***tt*��***:*#:****���*�***�
The undersigned hereby applies to the City of Orono for issuance of a
septic system installation permit, agrees to do all work in strict
accor�ance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application
are comp lete, true and correct.
Signature of Applicant: Date: � ZS -- �//�'�
MPCA Certification No. : .
✓
DATE TIME
CITY OF RONO CALLED IN � I a��O
INSPECT N N ICE SCHEDULED Q� 3:3C�J
PERMIT O. COMPIETED f� �
ADDRE
OWNER CONTR. � Crs�
TELEPHO E NO.
� DESCRIP ON
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
v3 03 INSULATIO 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREMIEfIANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 OEMO—SIT 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FIN L 27 SEPTIC MAINT. 21 COMPLAINT
i09 PLUMBING I 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING INAL AL
2 OWNERICONT CTOR TO MEET YOU: YES_NO � ,
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� ❑WORK SATISF CTORY:PROCEED —�PROJECT COMPLETE
W ❑CORRECT WO K&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WO K,CALL FOR REINSPECTION TEMPORARY
V BEFORECOV RING PERMANENT
❑CORRECT UN FE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECT R WILL RETURN
❑STOP ORDEH STED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION R QUIRED.CALL TO ARRANGE ACCESS.
Call f the next inspection 24 hours in advance.473-7357
OwnerlCont ctor -
inspector. �/
Wh te Copylinapector's File Canary Copy/Sita Notice