ST. LOUIS COUNTY, MN
PLANNING AND ZONING DEPARTMENT
(Onsite Wastewater Division)
Government Services Center
Government Services Center
320 West 2nd Street, Suite 301
201 South 3rd Avenue West
Duluth, MN 55802
Virginia, MN 55792
Phone (218) 471-7103
Phone (218) 749-0625
Toll Free (800) 450-9278
Toll Free (800) 450-9278
Annual Submittal of Holding Tank Records
Subsurface Sewage Treatment System
Your Contact Information.
If the information is not correct, you may need to update your contact information using the 'Edit Contact Info' option once you have filled out this application.
Kevin
Picek
1514 11th St S
Virginia
MN
55792
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k_picek@msn.com
Any
713-0015-03840
Enter Applicant Information
Landowner
No
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Kevin Joseph Picek
1514 11th St S
Virginia
MN
55792
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Any
Property Owner Name and Contact Information.
If the property owner information we have on file is not correct, please enter the current owner information.
PICEK KEVIN J
8844 CATTAIL DRIVE
BRITT
MN
55710
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k_picek@msn.com
(218)750-7463
Phone
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Mailing Address Information
This address can default from the address you selected. If the values defaulted are not correct, please enter the correct information.
Kevin Picek
1514 11th St S
Virginia
MN
55792
(218)750-7463
(218)750-7463
k_picek@msn.com
The Property Owner receives all Permit documents.
List any additional recipient emails separated by a semicolon.
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ATTACHMENTS
After submitting this form, please attach the following in the attachments screen:
Pumping Records/Receipts (by pumping episode for previous 12 months, if available)
Water Usage Records (for previous 12 months, if available)
Annual Holding Tank Questionnaire
By submitting this application, I certify and agree that I am the owner or the authorized agent of the owner of the above property, and that all uses will conform to the provisions of St. Louis County. I further certify and agree that I will comply with all conditions imposed in connection with the approval of the application. Applicants may be required to submit additional property descriptions, property surveys, site plans, building plans, and other information before the application is accepted or approved. Intentional or unintentional falsification of this application or any attachments thereto will make the application, any approval of the application and any result invalid. I authorize St. Louis County staff to inspect the property to review the application and for compliance inspections. Furthermore, by submitting this application, I release St. Louis County and its employees from any and all liability and claims for damages to person or property in any manner or form that may arise from the approval of the application or any related plans, the issuance of any resulting permit or the subsequent location, construction, alteration, repair, extension, operation or maintenance of the subject matter of the application.
If your name, contact information or email address have changed, you should update your contact information in the portal by selecting 'Maintain Contact Information' at the top of this page.
Kevin Joseph Picek
k_picek@msn.com
I have read and agree to the statement above.
