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HomeMy WebLinkAboutIowa Department of Natural Resources-2/6/2017Iowa Department of Natural Resources Wastewater Section Construction Permit Application Sewage Treatment Agreement INSTRUCTIONS This agreement must be executed for all projects where construction and sewage treatment will be provided by different parties; i.e., a private subdivision connecting to a municipal system. This agreement must be executed by the parties who are owners at the time the permit is issued, regardless of whether title to the proposed construction project will be transferred after completion of the project. This agreement is not necessary when a contract for sewage treatment already exists; i.e., service contracts between municipalities. However, the Department of Natural Resources must be informed in writing that the contractual agreement does exist. APPLICANT Owner: Midwest Development Co. ENGINEER Firm: Wayne Claassen Engineering and Surveying, Inc. Address: 411 1st Ave., SE,Suite 410, Cedar rapids, is 52401 P.O. Box 898, 2705 University Ave., Waterloo, la Address: 50704 Representative: Kevin M. Fittro Project Officer: Thomas J. Noonan Phone Number: 319-277-7862 Phone Number: 319-235-6294 Project Identification: Audubon Heights 6th Addition Owner and System Receiving Wastes: City of Waterloo, la CERTIFICATION I am the authorized representative of the owner identified above and state that the proposed sanitary sewage facilities shall be constructed in accordance with the plans and specifications and all wastes contributed by this project shall be discharged to the treatment system identified above. Signature ___-, Title: 1/, A Date /-0--/1 AGREEMENT TO PROVIDE SEWAGE TREATMENT I am the authorized representative of the owner of the system identified above and state that the connection of the proposed sanitary sewage facilities identified above is approved by the owner, and that the owner accepts responsibility for providing adequate treatment of all wastes contributed by this project, in accordance with the provisions of Chapter 455B, Code of Iowa, and the rules of the Department of Natural Resources. This agreement shall be construed in any way to affect any local ordinances, sewer service agreements, or fee systems entered into between the parties. Name: Title: Signature(k*/Date �/6 /i1 Phone: 11 lona r ......... r Mo C.....-, CAo 4110.10 IOWA DEPARTMENT OF NATURAL RESOURCES Wastewater Disposal System Construction Permit Application Fee Form CASHIER'S USE ONLY 0945-542-N PDE -CP -0570 32-3202 Owner Owner Name: City of waterloo, la Address: 715 mulberry St. City, State, Zip: Waterloo, la 50703 Project Identification: Audubon heights 6th Addition ® $100 Fee enclosed Please sign and return this form with a check or money order payable to "Iowa Department of Natural Resources". Place it and the check or money order on top of other Construction Permit Application documents. Effective beginning July 1, 2006, Applications for Construction Permits for wastewater disposal systems required by Iowa Code 455B.173 and rules in Iowa Administrative Code 567 IAC 64, must be accompanied by the fee required by Iowa Code 4556.197 and Iowa Administrative Code 567 IAC 64.16(3)"c". The fee is $100 for each application, regardless of project size and project type including sanitary sewers, pump stations, treatment units or a combination thereof. The fee shall be submitted with the certified engineering documents necessary to apply for a construction permit (plans, specifications and related application schedules A, F, and G as well as the appropriate schedules indentified on page 2 of Schedule A). The construction permitting process is initiated as planning for construction begins. Planning coordination and submittal of preliminary engineering reports or facility plans precedes submittal of technical documents necessary to constitute a construction permit application. The application fee is not necessary when submitting a planning document but must accompany construction permit application documents. A fee should accompany each permit application received on or after July 1, 2006. Failure to submit a fee with the application may delay the processing of a construction permit. If you have any questions regarding the application fee, please contact Donna Gomm at 515-725-8427 or Donna.Gomm@dnr.iowa.gov Signature of Owner or Representative: Printed Name: Telephone or email contact: Mail to: Iowa Department of Natural Resources Wastewater Engineering Section 502 East 9th Street Des Moines, IA 50319-0034 /64'44 a 1(.5 AA 11/2014 cmc DNR Form 542-1245 Exhibit 11A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE A, Construction Permit Application APPLICANT Owner: Midwest Development Co. 411 Ist Ave., SE, Suite 410, Address: 52401 Cedar Rapids, la Representative: Kevin M. Fittro Phone Number: 319-277-7862 Email: kfittro@skogman.com ENGINEER Firm: Wayne Claassen Engineering and Surveying, Inc. P.O. Box 898, 2705 University Ave., waterloo, la Address: 50704 Project Officer: Thomas J. Noonan Phone Number: 319-235-6294 Email: noonan@wcesinc.com Project Identification: Audubon Heights 6th Addition Estimated Start Date*: April, 2017 Estimated Completion Date: Sept., 2017 PLEASE RESPOND TO ALL QUESTIONS 1. Has an engineering report, facilities plan or other information previously been submitted for this project? If Yes: Project Identity: Date Submitted: 2. Does the project and construction permit application, as submitted, follow the recommendations, design loadings, ❑ ❑ construction schedule, permit limits, and conclusions of the approved engineering report or facilities plan? If No: Provide the design basis and technical information justifying all changes. 3. Are there three complete sets of plans and specifications accompanying this application? Yes No ® ❑ For a minor gravity sewer extension within the meaning of 4556.183.3 Code of Iowa and Design Standard 11.1, two complete sets will be adequate for expeditious approval. For more complex projects, three sets of plans and specifications may be requested. 4. Are approved standard specifications a part of this application? If Yes: Approved Standard Specifications of (municipality or firm): Date Approved: 5. Does each set of plans and specifications or engineering report accompanying this application contain a "professional engineering seal" executed in conformance with 5426.16, Code of Iowa? If No: Processing will be delayed pending receipt of applicable design schedules and certified plans, specifications or engineering report. 6. Is this a joint wastewater and water supply project? ® ❑ ® ❑ D If Yes: A construction permit application for the water supply project should be submitted separately to the Water Supply Section. A Water Supply permit fee may be required. 7. Is the applicant to provide treatment of effluent resulting from this construction? E If No: A Sewage Treatment Agreement executed by the authority providing treatment must accompany this form. 8. Is a new or amended operation permit necessary to use the facilities described in this application? If Yes: A new or amended permit to operate may be requested prior to the receipt of a construction permit. 9. Is any waterline located within 10 feet; or any private or public well, lake, or public recreation area located within 400 feet of the proposed construction? If Yes: Identify and locate the facility(ies) relative to the proposed construction. 10. Will construction inspection be conducted by a licensed engineer employed by the applicant? If No: Name of Engineering Firm Conducting Inspection: Wayne Claassen Engineering and Surveying, Inc. 11. Will this project utilize CWSRF loan funds? CERTIFICATION O El El -/ APPLICANT I certify that I am the authorized representative of the owner and state that the project identified above is approved by the owner. Signature Date 1, 21 Li'l *Estimated Construction Start Date: Complete applications must be submitted at least 1 construction in accordance with Rules 567 IAC 60.4 and 64.2 ENGINEER I certify that all aspects of the design included in this application conform to applicable standards contained in Chapter 567 IAC 64, or that an explanation and justification for any proposed variations from such standards is attached. I am familiar with the information contained in this application and, to the best of my knowledge, suc, nforma.io' '/: complete and accurate. Signature '� I Grp Date i �15'-./ 2 day in advance of the date for starting 04/2016 cmc DNR Form 542-3129: 28A Please complete the Schedule Checklist on the following page of this form. DOCUMENT CHECKLIST Identify all categories included in this project. Also, identify schedules attached to this application. Schedule B Collection System C Lateral Sewer Extension D Trunk & Interceptor Sewer E Wastewater Pump Station F Treatment Project Site Selection G Treatment Project Design Data H1 Schematic Flow Diagram H2 Treatment Process Loading and Removal Efficiency H3 Mechanical Plant Reliability Screening, Grit Removal and Flow Measurement J Septic Tank System K1 Controlled Discharge Pond K2 Aerated Pond K3 Anaerobic Lagoon L Setting Tanks M Fixed Film Reactor -Stationary Media N Rotating Biological Contactor O Aeration Tanks or Basins P Gas Chlorination Q Sludge Digestion and Holding R1 Sludge Dewatering and Disposal R2 (A&B) Low Rate Land Application of Sludge R3 Land Application of Sewage Sludge (To be developed) S Land Application of Wastewater (To be developed) Sewage Treatment Agreement Title Attached Included in Project Submittal Date E 0 ❑ ❑ 0 0 Identify any categories included in this project which are not provided in the above list of schedules. 04/2016 cmc DNR Form 542-3129; 28A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE B, Collection System Date Prepared Date Revised Project Identity Audubon Heights 6th Addition DNR USE ONLY Project No. Permit No. 1. Identify proposed construction which is subject to flooding and explain what is proposed to prevent water from entering the system. If no portion is subject to flooding, state none. Segment Flooding Protection *2. Indicate hydraulic capacity of: 1) the nearest downstream main or interceptor; 2) the nearest downstream lift station; and 3) all downstream segments where flow restriction may occur. Indicate the source and accuracy of numerical data. Location Design Capacity, MGD Peak Hourly Dry weather Flow MGD (actual) Peak Hourly Wet weather Flow MGD (actual) Segment Segment Segment Sergeant Rd. 21" Home Sergeant Rd. Park 48" Day 3.24 16.35 60+ 0.76 2.0 2.92 8.85 *3. Identify treatment facility, the design loadings and present raw waste loadings. Indicate source and accuracy of numerical data. Facility Name and Number Waterloo Water Pollution Control Plant IA 079001 FED 0042650 Facility Loading Design Average Wet Weather (actual) Peak Hourly Wet Weather (actual) MGD #BODs/da 34.8 • 88,000 31,500 Avg 24.53 Day 48,000 Peak 60+ Day Provide projected design loading increase, which will be added to this facility as a result of this project. Design Loading Initial Design Year (2037) Residential Service Area 0 Acres 24 Acres Population 0 Persons 172 Persons Flow (100 GPCD) 0 GPD 17,200 GPD BODS (0.17/#/d/cap) 0 #/day 29.24 #/day Industrial Service Area 0 Acres 0 Acres Rated Flow 0 GPD 0 GPD BODS 0 #/day 0 #/day Other 0 0 Acres 0 Acres Rated Flow 0 GPD 0 GPD BODS 0 #/day 0 #/day Total BODS 0 #/day 29.24 #/day Total Flow 0 GPD 17,200 GPD 11/2015 cmc DNR Form 542-3095; 28B Peak Hourly Flow 0 GPD 68,800 GPD *Include a written explanation of items 2 and 3 if the sewer system and/or treatment facility are overloaded. 11/2015 cmc DNR Form 542-3095; 28B Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE C, Lateral Sewer Extension Date Prepared Date Revised Project Identity Audubon heights 6th Addition DNR USE ONLY Project No. Permit No. 1. Design Basis Residential Service Area Population Flow (100 GPCD) BODS (0.17/#/d/cap) Industrial Service Area Rated Flow BO D5 Other Initial 0 Acres 24 Acres 0 Persons 172 Persons 0 GPD 17,200 GPD 0 #/day 29.24 #/day 0 Acres 0 Acres 0 GPD 0 GPD 0 #/day 0 #/day 0 Acres 0 Acres Rated Flow 0 GPD 0 GPD BOD5 0 #/day 0 #/day Total BOD5 0 #/day 29.24 #/day Total Flow 0 GPD 17,200 GPD Peak Hourly Flow 0 GPD 68,800 GPD 2. Pipe Diameter 8 Inch 10 Inch 12 Inch Material PVC PVC Joint Rubber Rubber Minimum Slope 0.40 % % 0.22 Maximum Manhole Space 285 ft. ft. 400 ft. Total Sewer Length 1519 ft. ft. 606 ft. Maximum Cover 13.0 ft. ft. 14.4 ft. Minimum Cover 9.8 ft. ft. 11.5 ft. 3. Construction specifications (indicate ASTM Number or other standard included in the specifications). A brief description is required in each part. A. Bedding class Class 1A, 95% STD Design Year (2037) B. Pipe laying C. Compaction D. Manhole D3034, D2321 D698, 95% C476, C433 E. Specified maximum infiltration/exfiltration rate 200 GPDPMPI F. Infiltration/exfiltration test procedures Air G. Alignment & grade test procedures (1) During construction Stake & batterboard Laser X (2) After construction Lamping X Other TV H. Deflection test procedures NA 4. Are detailed manhole drawings included: ® Yes ❑ No Typical frame and cover assembly Neenah R-1642 Are manhole covers nonvented: // Yes ❑ No Manhole diameter 48 in. Manhole opening diameter 24 In Material Precast PCC, Cast iron 5. Minimum sewer & water main separation: Horizontal 10 ft. Vertical 18 Are specifications included Yes in. 6. Stream, road, or railroad crossing protection No Are specifications included NA 11/2015 cmc DNR Form 542-3096; 28C