HomeMy WebLinkAbout2003-P06701 - sewer disconnect PERMIT
CITY OF ORONO Permit ►vumber:
2750 I�eiley Parkway - PO Box 66 Po6�oi
Crystal Bay, Minnesota 55323 Per'mit Type: Sewer and water Permit
(952) 249-4600 Date Issued: si2si2oo3
SITE ADDRESS: 1348 Rest Point Cir
Mound,MN 55364
P I D: 07-117-23-31-0023
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Disconnect
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
SAC Grandfathered In
FEE SUMMARY: PermitFee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Coppin Sewer&Water OWNER: Ace Properties LLC
5089 Shoreline Drive 1348 Rest Point Cir
Mound,MN 55364 Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA B ING CODE UIREMENTS.
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M.IC PERMI EESIGNATURE ISSUEDBYSIGNATURE
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Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
(Updated 6/2/03)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bav, �'IN 55323
GENERAL I�IFORMATION
l. You may apply for utility permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by return mail the same day
the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND
DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernut 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(952)249-4600,24 hour notice required.
JOB SITE ADDRESS: ���� -� �3y�'�CS'��O i n�- G-% '�
Occupancy Type: _�Residential Commercial
Owner's Name: Phone Number:
Mailing Address: City: Zip:
Contractor's Name: LAncc Cc��1;r� Phone Number: ���- a��d -�2b
Mailing Address: �d�g 5'G,mr� L,�,� �r- City: ����•�'� Zip:__,���C��
PERMIT TYPE ❑Connections ❑Repairs Disconnect (Check One)
- SAC Charge (2003 rate $1,275.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; material Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
(952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks=75'
REQUIlZED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well,sewer and water connection pernut requested.
3. Posta�e &Handlin� (Only mail-in applications) $ 1.50 (Mail In Only)
4. TOTAL PERMIT FEE (add lines 1-3 above) $
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work fln �trict
accordance with the ordinances of the ity and the regulations of the State of Minnesota, and certifies that all statera�ents
made on this application are co 1 true and co ect.
Signature of Applicant: -� Date: ����- U�
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`/� TIME
CITY OF ORONO CALLED IN � ��
INSPECTION NO���.�U� SCHEDULED -� � � �(�
PERMIT NO. COMPLETED
ADDRESS � � `f � 1 � �✓-� T 7` (� "� �
OWNER CONTR. � Y� °
TELEPHONE N0. � � � � � � '— �'� �-L
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� DESCRIPTION __ •
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPT FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL AETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (g52) 249-460�
OwnerlContr o ite:
Inspector.
White Copylinspeclor's File Canary Copy/Site Notice