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Home My WebLink AboutDNR FY2020 Lot 2 Brock 3rd Add Sanitary ewer Cont 986 - 12/30/19Exhibit 11A Iowa Department of Natural Resources Wastewater Section Construction Permit Application SCHEDULE A, Construction Permit Application APPLICANT Owner: City of Waterloo Address: 715 Mulberry St., Waterloo, IA 50703 Representative: Jamie.knutson Phone Number: 319-291-4312 Email: Jamie.knutson@WATERLOO-IA.ORG ENGINEER Firm: Wayne Claassen Engineering and Surveying Address: PO Box 898, Waterloo, IA 50704 Project Officer: William J. Claassen. PE Phone Number: 319-235-6294 Email: claassen@wcesinc.com Project Identification: FY 2020 Lot 2 Brock 3rd Add Sanitary Sewer Ext Estimated Start Date*: 04/01/20 Estimated Completion Date: 07/31/20 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 ❑SA_LEI 0 For a minor gravity sewer extension within the meaning of 455B.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): SUDAS 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? 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? 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 APPLICANT I certify that I am the authorized representative of the owner and state that the project identified above is approved by the owner. 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 i =/ knowledge, suc mformati n i-omplete and accurate. Signature Date '`` Signature Date <///l *Estimated Construction Start Date: Complete applications must be submitted at least 12 ays in advance of the date for starting construction in accordance with Rules 567 IAC 60.4 and 64.2 Please complete the Schedule Checklist on the following page of this form. 04/2016 cmc DNR Form 542-3129; 28A DOCUMENT CHECKLIST Identify all categories included in this project. Also, identify schedules attached to this application. Schedule Title Attached Included in Project Submittal Date 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 ❑ ❑ I 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 ❑ ❑ 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