HomeMy WebLinkAbout2004-P07348 - sewer/water connect CITY OF ORON PERMIT
� Permit Number:
2750 Kelley Parkway- PO Box 66 P07348
Crystal ��y, Minnesota 55323 Permit Type: Sewer and water Permit
(952)�249-4600 Date Issued: 3i3ii2ooa
SITE ADDRESS: 659 Sandstone Cr
I.ong Lake,MN 55356
PID: 33-118-23-11-0034
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pernut Sub-type(s): Sewer&Water Connections
Permit Type: Sewer and Water Pernut
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Westonka Water&Sewer OWNER: Dahlstrom Development LLC
6501 County Rd 15 7745 Polaris Lane
Mound,MN 55364 Maple Grove,MN 55311
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUE BY SIGNATURE
CoUies: 1-File(Signitures Required), 1-At�vlicant, 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
(ITpdated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL`INFORNIATION
1. +You may apply for urility pemuts 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 applicarion is received.
3. Permits are not valid until you receive a permit card. �
4. Work must not begin unless the pemut card is available on the job site.
5. Utility connection pernuts may be issved to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANl'STREET AND
DO NOT TAP AI�'Y 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: � � � ��C � � r��
Occupancy Type: Residential Commercial
Owner's Name: ;�� �2 �,��r4�, �e lt��:�,�S Phone Number:
NTailing Address: City: Zi :
Contractor's Name: ,.� Phone Numb : '.� �(7 - `/S.S 7
Mailing Address:��S�( � , t/' � City: M�,�v� _ Zip: Ss36�
PERMIT TYPE �Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,350.00) $ (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 f inches; material�Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size '7 inches; material C 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'
REQUIRED setback from sewer line= 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surcharee $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each�vell,sewer and water connection pernut requested.
3. Postage & 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 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 complete, true and c ect.
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Signature of Applicant: Date: 3 ��
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DATE TIME
CITY OF ORONO C LLED IN 3 3�I�'`JT
INSPECTION N TIC SCHEDULED --� �n:is
PERMIT NO. � � ��� COMPLETED
ADDRESS_ 5� :�1� � �%/ U�1 S'� (,�� �
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OWNER CONTR. l ,� �Q�����ZL.
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TELEPHONENO. �G7ca� `�'����' �(�'__��o��
� DESCRIPTION �`-�2 ��-C.
� 01 FOOTING 11 MECHANICAL RI 18 EX V/GRADING/FILLING
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 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTORTOMEETYOU:' YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
Owner/Contrac n i :
Inspector. _ C
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