HomeMy WebLinkAbout2004-P08033 - sewer connect CI l�F ORON PERMIT
� Permit Number:
27 Kelley Parkway- PO Box 66 P08033
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 10/5/2004
SITE ADDRESS: 1740 Shadywood Rd
Wayzata,MN 55391
PID: i�-ii�-23-2i-oo2o
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Pernut Sub-type(s): Sewer Connecrion
Permit Type: Sewer and Water Permit
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Grandfathered in
FEE SUMMARY: Pernut Fee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Thompson Plumbing OWNER: Robert&Joanne Switz �
15001 Minnetonka Ind.Rd. 1740 Shadywood Rd
Minnetonka,MN 55345 Wayzata,MN 55391
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.
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APPLICANT PERMITEE SIGNAT �— SSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1
Doc-04-1001 12:4dpm From-CITY OF ORONO +pg22464616 T-2G7 P.001/001 F-305
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� CITY OF ORONO A.PPL�CATION FQR UTILITY PER,MTTS
Box 6d(2750 KaUay Parkway) S�WEI2/WATER
Crystal�ay,MN SS323
CLNE L.INFORMATYON
l. You may sppty for util[ty permits by rna[1 ar i��persan at the Ciry ot�ices.
2, Mailed in applicaiions are aubject to the postage and handlin�fee showa below. Permit cards wilt be sent by
raturn mail tha same tlay the applieation is recr.ived.
3, Perm3t�are not vxlid until yon receivu s permit card.
4. �Vork must not begin unless the permit cerd ia available on the job site.
S. Utility connection perruits may be issued to licensed c�ontmotors only.
6, Coatact the Public Works Department (95?�249-4600) far utility stub as-bnilt latations. pQ NQT
EXC/�VATE IN ANY STRE�T AND DO NGT TAP ANY MAIN witho�t express approval of the Public
Woiics DeparomenL Issuance of a permit doos not @ant this approval.
7. AlI wark muet be done;n aecordenee with Sta�o Code roquiremeats.
, 8. AA wark must b�insp�cted before it is covere�l, Gtll(452)�49-4600.
24 hour noiiee reqnired.
.ro�a s�r�r,�n�a�ss: I rl �-�t�, `--�IZc��.��c ���. ���;�-
Oocup�cy T`ype:_ '� Residentiai Commercial
Uvruer'�Name; `�7`�--':t :���-� -�.�,,_�-�s-__� Phoae Number:
Maeliu��Addr�9: �l�t��,�,d, �� . � Citp: C-�< ��_��, 7�
Contrictor'a Name: . ., . � _ � PLanc Number:_ `i`�<�� `����`)
Mailin�Addresa:l�� � \i ,� �;�.r y�� �_ ,� City: �ti�.-+�'���. �i: '��=����
P�12MYT TYP�
Muaicipal Sewer Coanection($35A0 per stub) $ ���,C;��
1/e��� pipe si�c�inch�es; materi�I,,,,�,,,Schedule 40 air tested; cast iron
a`""'�°`' SAC Charge�2000 rate$1,150.Q0)must gccoiupan�atl sewtr peamit applications wiless prepaid
�' r If not prepaid,a sewer co�.n.ection permit will�wt be issued.
lVtuntcipal'VKAter Connoction{$35.00 per stub) >>-'�'� ` � c ��. $
pipe siu inah ; matcrial copper; other
WAT'ER METE�S must picked up and paiil for at City Hall.
Wxter met�rs mu3� bc ct xn$ seaied by (►rono Water Department (952-?,49-46p0) upon
completfon of inettr statllation.
REQ ' um sctbacks from drain field and septic tanks�75'
REQ set6a�tic�om scwcr l�ne=�U'
PFB�XT FF;;�;�'�Lb'I,7��
1. ��1�tot�s�f abc+�r�per.�:t rtqu�stcd $ '�>>,C��
2. Stata Surc�e $ .SQ -
T7�e Stata HuiEding Codc l7ivIsion Surchargo ai'$.SO per permit must ba
inaluded for oaah well,sawer and water aonna<:tion permit rcquQsted.
3. PastaQe&�andlir�g(4nly mail-in applications) $W -�
4. TOTA.L PERMIT FEE(add linos 1-3 above} $ ��,��,
The uadersigned hereby applies to the City of�hono for iasuance af a Utility Penni�, agrccs ta do
all work in sttfCt accordt�ttct with thc ordinances of the Cifiy and the regulations of the State of
Minncsota�and certif es that all statcments made on this�a}�plication are complete,true an�i correct.
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Signature of Applicant�L�, �2 �� :,�--E���Z ,�-(.� , ��. � _ ?a.