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1998-06-02 MPCA App for Permit ~- Minnesota Pollution Control Agency 520 Lafayette Road North, St. Paul, Minnesota 55155-4194 APPLICATION FOR PERMIT FOR SANITARY SEWER EXTENSIONS AND/OR CHANGES Instructions: FOR MPCA USE ONLY I. Date 1. Submit one completed application with one set of plans and specifications for each sanitary sewer extension and/or change. II. File No. 2. ALL portions of this application MUST be completed and signed if the sewer extension and/or change is to be considered. 3. An application fee is required under Minnesota Statutes section 116.07, subd. 4d (1990) and Minnesota Rules chapter 7002 (Permit Fee Rules). The fee is $240.00 per permit application and must be submitted with the application. Please make your check payable to the Minnesota Pollution Control Agency. III. CITY: Albertville, MN. COUNTY: Wright DATE: 6/2/98 IV. ENGINEER, FIRM: Westwood Professional Services, Inc. ADDRESS: 104 Marty Drive, Suite 3 Buffalo, MN 55313 V . SEWAGE TREATMENT PLANT, Name: Albertville PHONE: 682-2587 Is the proposed sewer project in accord with the City of District Comprehensive Sewer Plan? X (Yes) (No) VI. Title of Plans and Specs: Sanitary Sewer, Watermain, Storm Sewer, and Streets for Karston Cove First Addition Developer/Owner Name: Pilot Land Development Company Address: 13736 Northeast Johnson Street City: Ham Lake, MN 55304 Phone: 757-9816 VII. DESIGN OF GRAVITY SANITARY SEWER: Total Length of Pipe: 1641 feet Pipe Diameter(s): VIII. DESIGN OF PUMP ST A TION(S), No. of Pumps: -0- 8" inches STATION #1 PUMP #1 PUMP #2 STATION #2 PUMP #1 PUMP #2 Pump Capacity (gpm) Total Dynamic Head (ft) Length of Forcemain (ft) Forcemain Diameter (in) Forecemain Material Friction Factor (C) IX. ESTIMATED FLOW INCREASE: Initial: o MGD Project: 0.010 MGD Ultimate: 0.010 MGD Basis for estimate: 255 gal/day/ unit townhome The project flow should represent the design daily average flow from the completed project as proposed in this application. The ultimate flow should represent the design daily average flow from the proposed development and any areas that will ultimately be served by the proposed sewer extension. PQ-OO 139-07 1993 ,-......... . X. ESTIMATED BOD. INCREASE: Initial: 0 NIday Project: 1700 NIday Ultimate: 1700 NIday Basis for estimate: 17 #/100 gallons XI. NATURE OF AREA TO BE SERVED BY THE PROPOSED SEWER EXTENSION: (a) Residential: Number of New Homes: 38 Number of Existing Homes: -0- (b) Commercial/Industrial (Describe): -0- (c) Other (Describe): -0- XII. Will the proposed sewer project be designed and constructed as described in Standard Utilities Specifications prepared by the City Engineers Association of Minnesota? YES XIII. DETERMINATION AS TO THE NEED FOR AN ENVIRONMENTAL ASSESSMENT WORKSHEET: (Minnesota Environmental Quality Board Regulation) Please check as appropriate: Is the ultimate flow increase 500,000 gallons per day (gpd) or more and is the project service area within a city served either by the Metropolitan Waste Control Commission (MWCC) or the Western Lake Superior Sanitary Sewer District System (WLSSD)? Is the ultimate flow increase 500,000 gpd or more and is the project service area within a city with a population of 20,000 or more not served by either MWCC or WLSSD? Is the ultimate flow increase 100,000 gpd or more and is the project service area within a city not served by MWCC or WLSSD with a population less than 20,000 but at least 1O,000? Is the ultimate flow increase 50,000 gpd or more and is the project service area within an incorporated city not served by MWCC or WLSSD with a population less than 1O,000? Is the ultimate flow increase 50,000 gpd or more and is the project service area in an unincorporated sewered area? ' Yes No ~ ~ ~ ~ ~ If a yes answer was appropriate for any of the above conditions, then the preparation of an EA W is mandatory. Do you anticipate that a draft Environmental Assessment Worksheet (EAW) will be prepared by the city or county? Approximate date of completion of EA W NO SEWER CONSTRUCTION FOR THE REFERENCED EXTENSION MAY BE UNDERTAKEN UNTIL YOU ARE IN RECEIPT OF THE REQUIRED PERMIT(S) ISSUED BY THIS AGENCY AND AS DEFINED BY LAW UNDER MINNESO E ST T.O IVISION 3. Signed: Reg. No. 17716 Printed: Signed: Title: (J~ &r;/1Itv Printed: