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3. <br />Minnesota Pollution Control Agency <br />520 Lafayette Road North, St. Paul, Minnesota 55155 <br />APPLICATION FOR PERMIT FOR SANITARY SEWER E}:TENSIONS AND/OR C1IANGES <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 portions of this application MUST be completed <br />and signed if the sewer extension and/or change is <br />to be considered. <br />lication fee is required under Minnesota Statute 166.07, subd. ud, Supp. 1985 <br />An a ppFee <br />4�sd Minnesota Rules Chapter 7002 (Permit witliRthesapplication.isPlease make your <br />$80.00 per <br />permit application and must be submitted <br />check payable to the Minnesota Pollution Control Agency. <br />COUNTY: DATE: <br />CITY: PHONE: <br />ENGINEER, FIRM:=--�-- <br />ADDRESS: <br />��� i <br />SEWAGE TREATMENT PLANT, Name: ,IA-��-L' <br />T.s the proposed sewer project in accord with the city or District Comprehensive Sewer <br />Plan? (Yes) (No) <br />r) l 5 e-Lu-.r'1 W...�R .cx�., 15 l-0 5 t�..t r C� S ee i� u ►+ <br />Title of Plans and Specs: --`� _�n..�et_..,� �,.�►� .—�c'r+sr.•�(( , ���"e 1 lq-6y <br />77 <br />Developer/Owner Name: <br />Address: <br />City: <br />VI1. DESIGN GRAVITY SANITARY SF:IJI:R: --I— inches <br />TcAal Length of Pipe: 654-- feet Pipe Diameter(s): <br />VIA I.DISIGN OF PUMP STATION(S), <br />Pump Capacity p,pm) <br />Total Dynamic.Head (It) <br />t,ength of Forcemain (ft) <br />Forcemain Diameter (in) <br />Forcemain Material <br />Friction Factor (C) <br />IX. F.ST 1 MA'rf:D FLAW INCREASE: <br />Basis for estimate: <br />No. of Pumps: _— <br />STA*r rink if 1 STATION 02 n <br />1111 L I 'I <br />PiGI? Ultimate. <br />0, MGD <br />The. ultimate flow should represent the daily average <br />meat and any areas that will ultimately be served by <br />I1Q-00139-03 <br />1987 <br />flow from the proposed develop - <br />the proposed sewer extension. <br />