HomeMy WebLinkAbout1991-004003 - sewer connect PER1i�IIT
CITY OF ORONO � PERMIT TYPE:
1335�Brown Rd. South • P.O. Box 66 � :=�:t�F��« {��;�-��
Crystal Bay, Minnesota 55323 Permit Number: i ii 3�.Zi! =�
(612) 473-7357 Date Issued: �t-��'�;�%F 1
SITE ADDRESS:
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APPLICANT/PERMITEE S NATURE ��'�
ISSUED BY:SIGNATURE
CITY OF ORONO � APPLICATION FOR DTILITY PERMITS
Box 66 (1335 So Brown Rd) ,�� i SEW'$R WATER
Crystal Bay, MN 55323 .�;��' �
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I: You maI y�a ply�or utility pezmits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and ham3ling fees shown below.
Pernut cards will be sent by return mai 1 the same day the application is received.
3. Pexmits are nat valid until y�u reoeive a �mm;t card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits ma.y be issued to licensed contractors only.
6. Contact the Public Works Depart�ae.nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY STREE'r AND DO NOT TAP ANY MAIN without express approval of the
Public Works Departrnent. Issuance of a perniit does not grant this approval.
7. All work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 haur natiae required.
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JOB SITE ADDRRSS: U � � � `uS �C� ��
Occupancy Type: Residential Commercial
OWNER'S NAME: �d � �Je �.�, (� Phone No. : �1�,� �c� ��
Mailing Address : City:
CONTRACTOR'S NAIrII;: �4 `(� � O �I� Bus. Phone: � �-2� �
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Mailing Address: 2�v � ����� � City: ,CJc.�r1,f . Zip: b
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P$RMIT TYPE AND F.SE CALCDLATION
MIJNICIPAL S R CONNECTION ( $30 . 00 p ub) $
pipe size inches ; material PV on sand fill) ; cast iron
SAC Charge $650.00 ) must accompany sewer permit app�i ations unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MDNICIPAL WATSR CONNECTION ( $30 . 00 per stub) $
pipe size inches ; material copper; other
WATER METERS must be picked up and paid for at City Ha .
(5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 )
Water meters must be set and sealed by Orono Water Department (473-7357)
upon completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUiFED setback from sewer line = 20 '
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1. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must be
included for each well, sewer and water connection permit requested.
3 . Postage � Handling (Only mail-in applications) $ 1. 50
4. TOTAL PERMIT FE$ (add lines 1-3 above) $
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The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,
agrees to do all work in strict accordance with the ordinances of the City and the
regulations of the State of Minnesota, and certifies that all statements made on this
application are con�lete, true d correct.
� � JSignature of Applicant: Date: �,,� �C � '
DATE �,/ TIME
CITY OF ORONO CALLED IN �U' ���� �
INSPECTION NOTICE SCHEDULED fC' - i=/ �i.;_3 �%
PERMIT NO. connP�ErEo t( 1�
ADDRESS �� I ��G' ��L��� �- �� �
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OWNER /���� �� c �- CONTR. -C=>�-/ - �,_
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE ,, 14 SEWER HOOK-UP� 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑ COFiRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �7 CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlCont�or,dn site:
Inspector. V�u
White Copyllnspector's File Canary CopylSite Notice