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Home My WebLink About2004-P08064 - sewer/water connect CITY OF ORONO PERMIT 2750 htalley`Parkway - PO Box 66 Permit Number: Pogo64 Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit (952) 249-4600 Date Issued: loii2i2oo4 SITE ADDRESS: 2512 Sandstone La Long I.ake,MN 55356 PID: 33-118-23-11-0020 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connecrions DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: SAC Paid-8/9/04#P07810 FEE SUMMARY: Pernut Fee: $ 70.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 70.50 APPLICANT: John Terrance Homes,LLC OWNER: Dahlstrom Development LLC 8266 Xene Lane 7745 Polaris Lane Maple Grove,MN 55311 Maple Grove,MN 55311 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. � � � c�. � �� c�'� �� APPLICAN PERMITEE S[GNATU ISSUE BYS[GNATURE Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 (Updated 1/S/04) CITY OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (2750 T�elley Parkway) SEWER/WATER & SAC Crystal Bay, MN 55323 GENERAL INFORMATION 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. Pemut 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 pernut 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 utiliry stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works Deparnnent. Issuance of a pemut does not grant this approval, 7. All�vork must Ue 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: v�`� � � �S'"�'�S�1�V� �'�" � Occupancy Type: _�Residential Commercial Owner's Name: Phone Numbei-: Mailing Address: City: Zip: Contractor's Name: C�v\ Vv(r.�� eJ�KSPhone Number: Mailing Addi•ess: �� City: C�YU�,� Zip: PERMIT TYPE Coiulections ❑Repairs ❑Disconnect (Check One) SAC Charge (2003 rate $1,350.00) $ (Set Rate) Sac Charge must accompany all sewer pennit applications uilless prepaid. (If not p�•epaid, � sewer connection will not be issued) � � �� ✓/�`� � Municipal Sewer Connection/Disconne t/ epair ($35.00 per stub) $ � �� pipe size_�inches; material�Schd 40 air tested; cast iron � � Municipal Water Connection/Disconnect/�tepair($35.00 per stub) $ �1� ,(� , �� pipe size �-�` inches; material_�/ copper; other /l 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 tanlcs =75' REQUIRED setback from sewer line= 20' PERMIT FEE CALCULATION 1. Subtotal of above pennit requested $ 2. State Surcharee $ .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. Posta�e & 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 t11is application are complete, e d correct. Signature of Applicant: �� Date: 2l�"I DATE TIME � CITY OF ORONO CALLED IN INSPECTION N�TI�E SCHEDULED /D—lS--D�' -30 PERMIT NO. 4 d� c nn��E� ADDRESS 51 'J�al. �T�b OWNER CONTR. '� �� TELEPHONE NO. �. � � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WA�L BD. 12 ATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 EWER 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 PIUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO ti COMMENTS: � W a � J O >. � O � ti � Q � Z W � W � � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W p ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� Owner/ContractoJ,eyi it : Inspector. �� White Copyllnspector's File Canary CopylSite Notice