HomeMy WebLinkAbout2004-P08260 - sewer/water connect PERMIT
CITY C�r ORONO
2750 Ke"ley Parkway - PO Box 66 Permit Number: Pos26o
Crystal Bay, Minnesota 55323 Per'mit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: i2�6i2oo4
SITE ADDRESS: 717 Sandstone Cir
I.ong Lake,MN 55356
PID: 33-118-23-11-0046
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
SAC Paid#P08161 - 11/17/04
FEE SUMMARY: Pernut Fee: $ 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 1N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI PERMITEE SIGNATURE ISSUED Y SIGNATURE
Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(Updated 1/5/04)
CITY OF OR�vNO APPLICATION FOR UTILITY PERMITS
Box 66 (2Z�0 Kelley Parkway) SEWER/WATER& SAC a
Crystal Bay, MN 55323 1�'� �j�
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GENERAL INFORNIATION � � y
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. Peniut 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 pemut 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 stuU as-built locations. DO NOT EXCAVATE IN ANY STREET AND
DO NOT TAP ANY MAIN without express approval of the Public Works Deparhnent. Issuance of a pemut does not grant this approval.
7. All�vork must be done in accordauce with State Code requirements.
8. All work ntust be inspected before it is covered. Call(952)249-4600, 24 hour notice required.
JOB SITE ADDRESS: � ���� S�•-Z �S�ovt�✓ ���e�C�
Occupancy Type: � Residential Commercial
Owner's Name: �-�,�,,, ��ry,,,,cN (dv,,n�S Phone Number:
Mailing Address: City: Zip:
Contr�cto►-'s Name: ���[�� S/�,,� Phone Numbe ? ���S�`i
Mailing Addi•ess: (���[ CF�� �`�, �� City: �{, ��� , Zip: ��3�
PERMIT TYPE ,�Coimections ❑Repairs ❑Discounect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge uiust accotnpany all sewer pennit applications unless prepaid.
(If not prepaid, a se�ve►• connection will not be issued)
Muuicipal Sewer o ection/Disconnect/Re�air ($35.00 per stub) $
pipe size mches; material �chd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Re air ($35.00 per stub) �
pipe size�inches; material�opper; 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. SuUtotal of above pennit 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. Postage &Handling (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 correct. _
Signature of Applicant: Date: �
/� 3
AT TIME
CITY OF ORONO CALLED IN ��"�Y
INSPECTION NOTICE SCHEDULED �-/�� �
PERMIT NO.���[�C� COMPLETED Z'(�S'04 1�_C�O
ADDRESS 7/7��.rtc�?J'r�V1 L C Tf.
OWNER CONTR._1�Q..S'�Sk,���.—
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TELEPHONE NO. ��v� �70� ��Q
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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/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WA K-UP 17 SITE INSPECTION
Q OS FINAL 4 SEWER IiQOK-UP 06 PROGRESS
� 07 DEMO-SITE 'FTTC1 J�� . 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED j�PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ' ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
�CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46��
OwnedCon�ctor on site:
Inspector.
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