HomeMy WebLinkAbout2000-P02495 - plumbing � , PERMIT
CI_TY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po249s
Crystal Bay, Minnesota 55323 Pet'mit Type: Plumbing Water 1v�eter
(612) 249-4600 Date Issued: si2sioo
SITE ADDRESS: 1780 Shadywood Rd
WAYZATA,MN 55391
P I D: 17-117-2 3-21-0024
DESCRIPTION:
Proposed Use:
Permit Class: Plumbing
Permit Type: Plumbing Water Meter Permit Sub-type(s): Plumbing Undefined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 130.00 5/8"METER
TOTAL FEE: $ 165.50
APPLICANT: Anthony Patterson OWNER: ANT'HONY PATTERSON
1780 Shadywood Rd 1780 SHADYWOOD RD
Wayzata,MN 55391 WAYZATA,MN 55391
THE UNDERSIGNID 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 BUII.DING CODE REQUIREMENTS.
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I IS D SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
� CITY OF ORONO APPLICATION FOR UTILITY PERNIITS
Bu�66 (2750 Kelley Parkway) SEWER/WATER
� - -Crystal Bay, MN 55323 '
GENERAL INFORMATION �
1. You may apply for utility permits by mail or in person at the City offices. �
2. Mailed in applications are subject to the postage and handling fees 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 pemut card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Departrnent (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
Department. Issuance of a permit 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. Ca11249-4600.
24 hour notice required.
JOB SITE ADDRESS: � � �� �Ir��t �Oor) � '
Occupancy Type: � Residential Commercial
Owner's Name: „ � e„Scr,� PhoneNumber: 3 3� - � � 8 7
Mailing Address: � `j g0 S � �,, ��d �• City: �,��,�0 7ap:
Contractor's Name: �,�� y�r��.a,�,«� Phone Number:
Mailing Address: City: 7ap:
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge ($1,050.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other -
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters= $130.00; 3/4" meters= $180.00; 1" meters = $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Departmenf(249-4600) upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks= 75'
REQIJIRED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage &Handling (Only mail-in applications) $ 1.50
4. TOTAL PERNIIT 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 a11 statements made on this application are complete, true and correct.
Signature of Applicant: � Date: 2� �