HomeMy WebLinkAboutDepartment_of_Natural_Resources_-_Sewage_Treatment_Agreement_San_Marnan_Phase_2_-_3.2.2026Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
IOWA DEPARTMENT OF NATURAL RESOURCES
Wastewater Disposal System Construction Permit
Application Fee Form
Owner Name: John and Dan Properties LLC
Address: 7404 University Ave
City, State, Zip: Cedar Falls, Iowa 50613
CASHIER'S USE ONLY 1
0945-542-NPDE-CP-0570 '•
32-3202
Owner
Project Identification: San Marnan Business Park - Phase 2
0 $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. Or email a copy of
the form to webmaster@dnr.iowa.gov, cc'ing Donna.Gommmdnr.iowa.lgov, with the subject line: Credit Card Payment
for (Company Name), wait a minimum of 20 minutes after sending, then call 515-725-8200 to make the payment.
Effective beginning July 1, 2006, Applications for Construction Permits for wastewater disposal systems required by
Iowa Code 4556.173 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: Chris Fischels
Telephone or email contact: 319-830-5000 or Chris @crfre.com
Mail to:
Iowa Department of Natural Resources
Wastewater Engineering Section
6200 Park Ave Ste 200
Des Moines IA 50321
04/2024 cmc DNR Form 542-1245
Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
Iowa 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.
Owner:
Address:
Representative:
Phone
APPLICANT
John and Dan Properties LLC
ENGINEER
Firm: Clapsaddle-Garber Associates
7404 University Avenue, Cedar Falls, Iowa 50613
Address: 5106 Nordic Drive, Cedar Falls, Iowa 50613
Chris Fischels
Project Officer: Adam Daters
Number: 319-830-500
Phone Number: 319-266-0258
Project
Owner
Identification: San Marnan Business Park - Phase 2
and System Receiving Wastes: City of Waterloo STP - 790001
I am the
constructed
treatment
Signature
CERTIFICATION
authorized representative of the owner identified above and state that the proposed sanitary sewage facilities shall be
in accordance the plans . 4 . 4..: ' . . . . itributed by this project shall be discharged to the
system iden ' d a ve. sign h- -
-- — Title: is-n“-- Date 1- ----
I am the
sanitary
adequate
the rules
sewer service
Name:
SignatL
AGREEMENT TO PROVIDE SEWAGE TREATMENT
authorized representative of the owner of the system identified above and state that the connection of the proposed
sewage facilities identified above is approved by the owner, and that the owner accepts responsibility for providing
treatment of all wastes contributed by this project, in accordance with the provisions of Chapter 455B, Code of Iowa, and
of the Department of Natural Resources. This agreement shall not be construed in any way to affect any local ordinances,
agreements, or fee systems entered into between the parties.
Dave Boesen Mayor
Ci0nac1 hy. Title:
re4A.t, 17 t,St,la, Date 03/02/2026 Phone:
9/2018 cmc
DNR Form 542-3219; 29
Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
Exhibit 11A
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SCHEDULE A, Construction Permit Application
Owner:
Address:
APPLICANT
John and Dan Properties
7404 University Aven, Cedar Falls, Iowa
ENGINEER
Firm: Clapsaddle-Garber Associates
50613 Address: 5106 Nordic Drive, Cedar Falls, Iowa 50613
Representative: Chris Fishels
Phone Number: 319-830-5000
Email: chris@crfre.com
Project Officer: Adam Daters
Phone Number: 319-266-0258
Email: adaters@cgaconsultants.com
Project Identification: San Marnan Business Park - Phase 2
Estimated Start Date*: July 2025 Estimated Completion Date: November 2025
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. Is there an electronic set of plans and specifications accompanying this application?
Attachment size is limited to 25MB. Please use zip files or other options to submit attachments greater than 25MB.
4. Are approved standard specifications a part of this application?
If Yes: Approved Standard Specifications of
(municipality or firm): Sudas 2024 Edition 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 542B.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?
0 ❑
0 ❑
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:
11. Will this project utilize CWSRF loan funds?
CERTIFICATION
❑ ❑X
❑ ❑X
❑ 0
El El
El
APPLICANT
certify that I am the authori repFesentative of the owner and state that the project identified above is approved by the owner.
Signature
sign her
Date
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 containarl in this annliratinn anal to the best of my knowledge, such information is complete and accurate.
Signature - Date 1-30-26
*Estimated Co..— IFIc« applications must be submitted at least 120 days 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.
09/2024 cmc DNR Form 542-3129; 28A
Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
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 ❑X ❑X
C Lateral Sewer Extension ❑X ❑X
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 ❑X ❑X
Identify any categories included in this project which are not provided in the above list of schedules.
09/2024 cmc DNR Form 542-3129; 28A
Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SCHEDULE B, Collection System
DNR USE ONLY
Project No.
Permit No.
Date Prepared
5/21/2025
Date Revised
Project Identity
San Marnan Business Park - Phase 2
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
n/a
n/a
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.
Segment Segment Segment
Location
Design Capacity, MGD
Peak Hourly Dry weather Flow MGD (actual)
Peak Hourly Wet weather Flow MGD (actual)
8" Sewer GIS ID
30155-27073
0.47
0.007
0.21
*3. Identify treatment facility, the design loadings and present raw waste loadings. Indicate source and accuracy of numerical data.
Facility Name and Number Waterloo City of STP - 790001
Facility Loading
Design
Average Wet Weather (actual)
Peak Hourly Wet Weather (actual)
MGD
#BOD5/day
34.8
88,000
24.53
31,500
60+
48,000
Provide projected design loading increase, which will be added to this facility as a result of this project.
Design Loading Initial Design Year ('35 )
Residential Service Area 0 Acres 0 Acres
Population 0 Persons 0 Persons
Flow (100 GPCD) 0 GPD 0 GPD
BOD5(0.17/#/d/cap) 0 #/day 0 #/day
Industrial Service Area 0 Acres 0 Acres
Rated Flow 0 GPD 0 GPD
BOD5 0 #/day 0 #/day
Other Commercial 0 Acres 4.6 Acres
Rated Flow 0 GPD 23,000 GPD
BOD5 0 #/day 40 #/day
Total BOD5 0 #/day 40 #/day
Total Flow 0 GPD 23,000 GPD
Peak Hourly Flow 0 GPD 92,000 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
Docusign Envelope ID: 2BA02A85-E195-4590-93B8-E23065DB8755
Iowa Department of Natural Resources
Wastewater Section
Construction Permit Application
SCHEDULE C, Lateral Sewer Extension
DNR USE ONLY
Project No.
Permit No.
Date Prepared
5/21/2025
Date Revised
Project Identity
San Marnan Business Park - Phase 2
1. Design Basis
Residential Service Area
Population
Flow (100 GPCD)
BOD5 (0.17/#/d/cap)
Industrial Service Area
Rated Flow
BOD5
Other commercial
Initial
Design Year
0 Acres 0
0 Persons 0
0 GPD 0
0 #/day 0
0 Acres 0
0 GPD 0
0 #/day 0
0 Acres 4.6
Rated Flow 0 GPD 23,000
BOD5 0 #/day 40
Total BOD5 0 #/day 40
Total Flow 0 GPD 23,000
Peak Hourly Flow 0 GPD 92,000
2. Pipe Diameter 8 Inch 10 Inch 12 Inch
Material PVC, SDR 26
Joint Bell & Spigot
Minimum Slope 0.4
Maximum Manhole Space 324 ft. ft. ft.
Total Sewer Length 560 ft. ft. ft.
Maximum Cover 12.5 ft. ft. ft.
Minimum Cover 8.3 ft. ft. ft.
( 2035 )
Acres
Persons
GPD
#/day
Acres
GPD
#/day
Acres
GPD
#/day
#/day
GPD
GPD
3. Construction specifications (indicate ASTM Number or other standard included in the specifications). A brief description is
required in each part.
A. Bedding class SUDAS Section 3010
B. Pipe laying SUDAS Section 4010
C. Compaction SUDAS Section 4010
D. Manhole SUDAS Section 6010
E. Specified maximum infiltration/exfiltration rate 200 GPDPMPI
F. Infiltration/exfiltration test procedures Low Pressure Air
G. Alignment & grade test procedures
(1) During construction Stake & batterboard
(2) After construction Lamping
H. Deflection test procedures Mandrel Test, SUDAS Section 4060 3.05
Laser
Other Television
4. Are detailed manhole drawings included:
Yes ❑ No Typical frame and cover assembly NEENAH R-1642 Self Sealing
Are manhole covers nonvented: Yes ❑ No Manhole diameter 48 in.
Manhole opening diameter 27 (SUDAS Typ) In Material Cast Iron
5. Minimum sewer & water main separation: Horizontal 21' ft. Vertical N/A in.
Are specifications included SUDAS 2024
6. Stream, road, or railroad crossing protection N/A
Are specifications included
11/2015 cmc
DNR Form 542-3096; 28C