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<br /> <br />Minllesota PollutiQn Control Agency <br />5~O,Lafayette Road North, 81. Paul, Minnesota 55155-4194 <br />. . , . <br />_ ~ . ~ \ " " 101 ,,' I ~ ~ <br />'-'APPLIClTI6N FO~'~EkHIT FOR SANITARY SEVER EXTENSIONS AND/OR CHANGES <br /> <br /> FOR MPCA USE ONLY;, ~ <br />I. Date , . ' <br />II. File No. <br /> <br />': Instructions: <br />j <br /> <br />1. Submit one completed application with one set of <br />, plans and specifications for each sanitary sewer <br />extension and/or change. <br /> <br />i. ALL portions of this application MUST be completed <br />and signed if the sewer extension and/or change is <br />to be considered. <br /> <br /><II!'.. . <br />3. An application fee is required under Minnesota Statutes section i16.07, subd. 4d <br />(1990) and Minnesota Rules chapter 7002 (Permit Fee Rules). The fee is $240.00 per <br />permit application and must be submitted with the application. Please make your <br />check payable to the Minnesota Pollution Control Agency. ' <br /> <br />III. , CITY: (;) ~'t. ,\ \~ COUNTY: <br />IV. ENGINEER, FIRM: E",- ~ ~ e e... ~ ' 4::t-\t... <br />ADDRESS: r f- 'I)" ~. ~';'ver e.ccut ~LO"'3. <br />I <br />V. SE\1AGE TREATMENT PLANT, Name: -1'J\ 0{ +- VCl <br />Is the proposed sewer project in accord with the City of District Comprehensive Sewer <br />Plan? ~ (Yes) <br />VI. Title of Plans and Specs: <br /> <br />Developer/Owner Name: <br />Address~ <br />Ci ty: <br />VII. DESIGN OF GRAVITY SANITARY SEYER: <br />, :rotal Length of Pipe: 2- 1- 9 feet <br />VIII. DESIGN OF PUMP STATION(S), No. of Pumps: <br />STATION 1t1 <br /> <br />""'-~e.f <br /> <br />DATE: 2. f-19S- <br />paONE: 7Z)')-62Jf<} <br />Mil ~, '/'AN ))"'83 <br /> <br /> <br />Phone: <br /> <br />32 14 <br /> <br />Pipe Diameter(s): <br />-0 .- <br /> <br />r:J 'I <br /> <br />inches <br /> <br />STATION ~2 <br /> <br />PUMP n <br /> <br />PUMP #2 <br /> <br />PUMP #2 <br /> <br />PUMP #1- <br /> <br />Pump Capacity (gpm) <br />Total Dynamic Bead (ft) <br />Length of Forcemain (ft) <br />Forcemain Diameter (in) <br />Forcemain Material <br />Friction Factor (C) <br /> <br />~ IX. ESTIMATED FLOV- -INC~~~~E~ ,Ini tial: ~ 060'LMGD Project,: O. OJ 'I- MGD Ultimate,: 0.00 f- HGD <br /> <br />Basis for estimate;'''. /< 't{(5i1~ K.J\.4t.e.l~~ca ~)::" 2. >f Pf:,/~J~'r}.'~:lM\s/J1:./0!>''I: <br /> <br />The project flow should represent the design daily average flow from the completed <br />project as proposed in this application. The ultimat'Et~,fdow shou'1d:i:'epresent the <br />design daily average flow from the proposed development and any areas that will <br />ultimately be served by the proposed sewer extension. <br /> <br />PQ-00139-07 <br />1993 <br />