RILEY COUNTY PLANNING & DEVELOPMENT
110 Courthouse Plaza
MANHATTAN, KS 66502
(785) 537-6332, EXT. 7505
Application:
WASTE STABILIZATION POND
Lagoon Site Address: ___________________________________________________________________________
(Street) (City) (Zip Code)
Le
gal Description: (copy may be attached)__________________________________________________________
Hom
e Phone_____________ Work Phone______________ Cell Phone____________
I, _________________________________________________________, present mailing address is:
_______________
_______________________________________________________________________________
(Street) (City/State) (Zip Code)
do h
ereby apply to construct a waste stabilization pond to serve a single family dwelling
which will be located on a tract
described as follows:
• Size of property acres (minimum of 3 acres required)
• Number of people to be served
• Number of bedrooms
• Volume of sewage discharged (if known) gallons/day
•
Floodplain restrictions
(out of the 100 year plain)
Nam
e of licensed installer: ____________________________________________________
I hereb
y certify the information on this application is true and correct to the best of my knowledge and belief.
Dat
e: ______________________ Signature of applicant: ______________________________________
Preliminary proposal approved this _______day of _______________________, _________ for a single cell
waste stabilization pond design M-_____, with a maximum sewage flow of ________________gallons per month
(and becomes invalid should the flow exceed this rate) with special requirements as follows:
Over excavate any rock layer encountered by a minimum of 18” and then line the lagoon with approved materials.
Incorporate 400 lbs of rock salt into the top two, 9” lifts which have been compacted to 6”. Adequate moisture must be
present for proper compaction. Final compaction must be in compliance with the Riley County Standards. Install
an approved fence, gate, lock, and seed with an approved grass prior to occupying the home. Maintain all required
setback distances. This permit is good for one year. Call for inspections.
by ______________________________________________
**********************************************************************************************
WASTE STABILIZATION POND USE PERMIT
This final permit is herby issued this _____ day of ___________, ______
by ______________________________________________
Y:\Forms\Enviromental\Fillable PDF's
Log # ___________________
Receipt # ________________
Date Rec’d_______________
Pd : Check …….…#_______
Cash………….._______
$ 300.00 (new fee)
$ 75.00 (repair of system)
click to sign
signature
click to edit
![]()
