Western Lake Superior Sanitary District Sanitary Sewer Extension Application Instructions: Please answer each question completely, providing as much information as possible and submit to WLSSD Planning Department located at 2626 Courtland Street, Duluth, MN 55806. Attach any maps, photos or other material that will be helpful during the review process. Extra sheets may be attached if necessary to accommodate text and/or data. Your application will be returned if all of the required information is not provided. A completed Minnesota Pollution Control Agency (MPCA) Sanitary Sewer Extension Permit Application must be submitted to WLSSD along with the WLSSD application and required documents. More information and the MPCA application may be found at: http://www.pca.state.mn.us/water/permits/index.html#sanitarysewer. Applications must be submitted no later than 10 days prior to a scheduled WLSSD Planning Committee meeting for consideration (please call for scheduled dates 218-7223336). Review Process: Upon receipt of the completed application, WLSSD staff will review the submitted information for completeness. After review by District staff, the application is either sent back to applicant requesting more information or presented by WLSSD staff to the WLSSD Board Planning Committee for review prior to a review by the full WLSSD Board of Directors. o For Committee review, applications must be submitted no later than 10 days prior to a scheduled committee meeting. Applications received fewer than ten (10) days prior to a scheduled Planning Committee meeting will be reviewed at a subsequent meeting. Please contact WLSSD Planning Department for upcoming committee meeting date(s). o Planning Committee meetings are scheduled as needed, typically monthly. o The WLSSD Board convenes on the third or fourth Mondays of the month at 5:00 p.m. in the WLSSD Administrative Building located at 2626 Courtland Street. The Board meeting schedule can be found at the WLSSD web site at www.wlssd.com. Should the District Board approve the extension request, the application is then forwarded, by WLSSD, to the Minnesota Pollution Control Agency for their review. Should the District Board deny the application, the application will be returned to applicant stating reasons for denial. Western Lake Superior Sanitary District Sanitary Sewer Extension Application Project Name: ____________________________ Applicant: ___________________________________________ Owner: ___________________________________________ Date: _________ 1. Please describe the proposed project, including its location, existing and future area(s) to be served, streets and water resources. Specifically include a copy of the following: Attach a site map of the entire project area including: location of existing and proposed sewer, property lines, roads, buildings, and other significant physical features; Attach a piping system map (plan and profile) with pipe sizes, diameters, compositions and lengths of each. 2. Provide a copy of the completed MPCA’s “Sanitary Sewer Extension Permit Application”. 3. Who will be responsible for future operation and maintenance of the proposed sewer utility? 4. On October 6, 2003, WLSSD established minimum standards for Design, Construction, and Inspection of District sewer system assets and connected municipal sewer lines (see attached resolution 03-21). Please complete Design and Construction Standards checklist and submit with this application. If located within the City of Duluth, does the design meet all the requirements of the City of Duluth Master Specification? PROJECT ENGINEER Signature:________________________ Printed name: Reg. No._____________ ________________________ CITY OR TOWNSHIP REPRESENTATIVE Signature:_________________________ Printed name: Title________________ _______________________ This Application form and accompanying attachments can be found on WLSSD’s website at: http://www.wlssd.com The Minnesota Pollution Control Agency Sewer Extension information and forms can be found at the following web site: http://www.pca.state.mn.us/water/permits/index.html#sanitarysewer. Answers to question #6 on the MPCA Sanitary Sewer Extension Permit Application 6) Specification of current WWTF (Wastewater Treatment Facility) where flow will be treated. a) b) c) d) e) Where will the wastewater be treated? WLSSD Design Average Wet Weather flow (AWW) 48.4 MGD Actual current annual average daily flow received in the past 12 months) 38.1 MGD Actual current annual average daily CBOD5 loading in the past 12 months) 191 mg/L Estimate the total number of new connections anticipated, including other projects, in the next 12 months. (your municipality provides this information) f) Do the downstream collection facilities and WWTF have sufficient capacity to treat current flow and the flow from this and other approved connections not yet constructed? (Your municipality provides this information in consultation with WLSSD)