HomeMy WebLinkAbout2004-P07677 - sewer/water connect PERMIT
CITY C�,F ORONO
2750 heiley Parkway - PO Box 66 Permit Number: Po�6��
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: �i2i2oo4
SITE ADDRESS: 716 Sandstone Cr
Long Lake,MN 55356
PID: 33-118-23-11-0050
DESCRIPTION: -� -
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Proposed Use: Residential ��`�,0.�� �
Pernut Class: General � /
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Pernut Sub-type(s): Sewer&Water Disy�inectic
Pernut Type: Sewer and Water Permit ! -
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Paid#P07643 -06/28/04
FEE SUMMARY: PermitFee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Westonka Water&Sewer OWNER: 7ohn Terrance Homes, LLC
6501 County Rd 15 8266 Xene 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 PE EE SI RE [ UED BY SIGNATURE
Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessins, 1-Finance Page 1
(Updated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (::750�Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORiV1ATION
1. You may apply for utility pernuts 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 pernvt card is available on the job site.
5. Utility comiection 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 Deparmzent. Issuance of a pemut does not grant this approval.
7. All work must be done in accordance with State Code requirements.
8. All work must be inspected befare it is covered. Call(952)249-4600, 24 hour notice required.
JOB SITE ADDRESS: 7�� �+'� (�►�av�� ����Ic�
Occupancy Type: �Residential Commercial
Owner's Name: �✓�-��„c� 1fo�c'S Phone Number:
Mailing Address: City: Zi :
Contractor's Name: �:�- �� c� Phone Number• �r'S-���i7�-yys-�
Mailing Address: ��� Lo. ,� r �S City: ,. Zip: 55"3dy
PERMIT TYPE [�Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accoinpany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer �nnection/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 metei,s 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 Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit 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 e and correct.
Signature of Applicant: Date:
DATE TIME "
CITY OF ORONO CALLED IN s�'& �� .
INSPECTION N TICE SCHEDULED �
PERMIT NO. `? lO��7 COMPLETED
ADDRESS �%�o � �'''�
OWNER .�"'/t,n l��t�ut- �� CONTR. !r�'Z�%�-a- '.�
TELEPHONE N0. �5�' �f 7 2� �f yf��r' �
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24 IREPLACE 34 TREE REMOVAL
Z04 WALL BD. , �i 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �-1 CITATION ISSUED
❑ INSPECTIOIV REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance. (952� 249-4600
OwnerlCon n i :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice