HomeMy WebLinkAbout2003-P06991 - sewer connection ` � PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po6991
Crystal Bay, Minnesota 55323 Pe►'mit Type: Sewer and water Permit
(952) 249-4600 Date Issued: iiii2i2oo3
SITE ADDRESS: 250 Ruann Rd
Wayzata,MN 55391
PID: 36-118-23-32-0002
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: V P Enterprises OWNER: Paul&Kay Studebaker
P.O.Box 15 250 Ruann Rd.
Wayzata,MN 55391 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(iJpdated 6/2/03)
CI�i Y G� ORONO APPLICATION FOR UTILITY PERMITS �
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, NIN 55323
GENERAL INFORl�IATION
1. You may apply for urility permits by mail or in person at the City offices.
2. Mailed in applicarions 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 be;in unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed conh-actors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locarions. DO NOT EXCAVATE IN ANY STREET AND
DO NOT TAP A�1Y MAIN without express approval of the Public Works Department. Issuance of a permit 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.
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JOB SITE ADDRESS: Z �' t� ___ (/�� 1
Occupancy Type: Residential Commercial
Owner's Name: /t/ /-�- Phone Number:
Mailing Address: �. A._ City: Zip:
Contractor's Name: �/ f`„�-}���i(i,r 5 c� � I'�'',cJ�,..� Phone Number: �/s2_ Y�3- 3 57�
Mailing Address: .�p City: (•✓.4c z�: Zip: � s���/
PERI�IIT 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 se���er connection will not be issued)
Municipal Sewer nnection/Disconnect/Repair ($35.00 per stub) $_ ..
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pipe size�inches; material chd 40 air tested; cast iron
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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.
REQLJIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED 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 permit must be
included for each���ell,sewer and water connection pernut requested. �
3. Posta�e & Handlin; (Only mail-in applications) $ 1.50 (Mail In Only)
4. TOTAL PER�iIT 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 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 ar true and correct.
Signature of Ap nt: Date: /���
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CITY OF ORONO CALLED IN /
INSPECTION NOTJ����,/ SCHEDULED - ` �1�
PERMIT NO. t� COMPLETED ��Z-y'�3 � -()C�
ADDRESS /�
OWNER CONTR. ��e/ ��-2S
TELEPHONE N0. ���� �� � ��� ` ��
� DESCRIPTION �%��� �a��fd�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLWG
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL �
Z 04 WALL BD. 12 WATER HOOK•UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 OEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FI 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU: YES_NO {
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� ❑INORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W O CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPOflARY
V BEFOREC�IERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next ins�ction 24 hours in advance. (952) 249-4600
OwnedContra or on site: �
Inspector. '7v�-c-�
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