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Minnesota Pollution Control Agency <br />520 Lafayette Road North, St. Paul, Wnnesota 55165 —,.,^a, cno OPOWT FAR SANITARY SEWER EXTENSIONS AND/OR CHANGES <br />nrrLIUMI LW" ' ' <br />Instructions: <br />1, Submit one completed application with one set of <br />plans and specifications for each sanitary sewer <br />extension and/or change. <br />2. ALL port ions of this application MUST be completed <br />and signed if the sewer extension and/or change is <br />to be considered. <br />3. An application <br />fee is required under Minnesota Statutes section 16.0 ,he fee is ubd .00dNer <br />(1986) and Minnesota Rules ch�Ps�bmi�ted(Permit <br />theFee <br />application. Please make your <br />permit application and must b <br />check payable to the Minnesota Pollution Control Agency <br />aQ <br />COUNTY: , �l M `r`____--- UA'- k : <br />III. CITY: —J�as-- �,�ic�c. -- PHONE: _q�Q 72 <br />IV. ENGINEER, FIRM: mar y s r-�a� �YI+a. 5"sll7 <br />ADDRESS: ?- t_ T T 4- <br />'�► re. �1� <br />SEWAGE TREATMENT PLANT, Name: Citynor District Comprehensive Sewer <br />Is the proposed sewer project in accord with <br />(Yes) .,.e._,.�.....- <br />Plan? _. .------ f, -n a <br />Specs: s rt� c� t�{ter •� - t_-.,..�.,... <br />VI. Title of Plans and p <br />Developer/Owner Name: l #':. Address:- <br />� i i rrrCr � fY. .�: }one: 2y s <br />City: art. - _....�.. <br />rr * <br />VII. DESIGN OF GRAVITY SANITARY SEWER: inches <br />Total Length of Pipe: �►� yc� feet Pipe Diameter(s): <br />VIII.OES1GN OF PUMP SiATIONf�. Nn_ of PUMPS: _ <br />Pump Capacity (gpm) <br />Total Dynamic Head (ft) <br />Length of Forcemain (ft) <br />Forcemain Diameter (in) <br />Forcemain Material <br />Friction Factor (C) <br />IX. ESTIMATED FLOW INCREASE: Initial: ��c, <br />MOD Ultimate: MOD <br />r 17�1 000 �.tI rC A" 1 <br />Basis for estimate: <br />flaw should represent the daily average flow oeseweproextensivnnp- <br />The ultimate the proposed <br />ment and any areas that will ultimately be served by <br />PQ-00139-04 <br />1988 <br />