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Home My WebLink About2004-P07260 - sewer/water connect � -'� PERMIT CITY QF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P07260 Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit (952) 249-4600 Date Issued: 2i2si2oo4 SITE ADDRESS: 2474 Sandstone La I.ong Lake,MN 55356 PID: 33-118-23-11-0027 DESCRIPTION: Proposed Use: Residential Pemut Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections 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 UNDIItSIGNID HIItEBY REQUESTS PIItMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFTED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WPI'H ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUII,DING CODE REQUIItIIVIINTS. � C� � APPLICANTPERMITEESIG TURE ISSUEDBYSIGNATURE Conies: 1-FIle(SiQnitures Required). 1-Annlicant, 1-Monthlv Renorts, 1-Assessing, 1-Finance Page 1 _* (LTpdated 1/5/04) CIT'Y OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC Crystal Bay, MN 55323 GENERAL INFOR«ATION 1. You may apply for utility pernuts 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 retum 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 permit card is available on the job site. 5. Utility connecrion 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 A��,'1'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• ;��`� S�. ��5��'��J L �� Occupancy Type: ��Residential Commercial Owner's Name: �E��n �i�;�° =,�c,c jf��c��S Phone Number: Mailing Address: City: Zi : Contractor's Name: ;,�e ov� �� S' Phone Number: �rS� Nlailing Address: �S�/ Co. 2 . [�— City: %�cou�►� Zip: �36y PER'VIIT 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�inches; material�Schd 40 air tested; cast iron Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $ pipe size ;7_ 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 l. 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 w�ell,sewer and water connection pernut requested. 3. Postage & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only) 4. TOTAL PERl�1IT 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 corr t. Signature of Applicant: Date: � .�� D � /I V � ATE i� TIME CITY OF ORONO CALLE�iN �� -S — � INSPECTION NOTICE SCHEDULED Z-�� Czf � ��c�C� � PERMIT N0. �C7�2- COMPLETED ADDRESS � �l �7�� CA r�.�' S`7a L� OWNER CONTR. ��'S�'h-��= S1`f/� TELEPHONE N0. �S Z y7� �I�t.S-c� � � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE T. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIG INSTALL 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FIN 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � � d W� ORKSATISFACTORY: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 INSPECTOF ❑CITATION ISSUED ❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� Owner/Contracto�,e i{� Inspector. � White Copyllnspector's File Canary Copy/Site Notice