HomeMy WebLinkAbout2000-P03237 - sewer/water permit PERMIT
C I TY O F O RO N O Permit Number:
275C Ke�le"y Parkway - PO Box 66 P03237
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(6�2) 249-4600 Date Issued: ti�si2oo
SITE ADDRESS: 1875 Shadywood Rd
WAYZATA,MN 55391
PID: 17-117-23-24-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit T e: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
yp Water Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SU1111MARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: RITTER EXCAVATING OWNER: MARK&GINA KOSEK
7120 VERNON STREET 1875 SHADYWOOD RD
ROCKFORD,MN 55373 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMl'LIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI T PERM EE SIGNATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
,� , li�� 66 (2750 Kelley Parkway) SEWER/WATER � ��
Crystal Bay, MN 55323 �a ?'
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 permit card is available on the job site.
�. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(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
Deparhnent. 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: ���.� � �'Y'Y'r"l �
Occupancy Type: Residential Commercial
O�vner's Name: Phone Number:
Mailing Address: City: 7�p:
Contractor's Name: ���.- , ��a /r.� �Y,�--�t�'Phone Number:�/1 >/ j -%�f� /
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NTailing Address: 7/ Z�i 7/�-,�.a,� �—e"/ City:.1��`�t Zip: � ,, �
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $ -�-,`� ° z'
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
l�7unicipal Water Connection ($35.00 per stub) $ �`S " `'
pipe size inches; material copper; other
W'ATER METERS must be picked up and paid for at City Hall.
`Vater meters must be set and sealed by Orono Water Department(249-4600)upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks= 75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $ 7 � �� �
2. State Surcharge $ .50
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Posta�e & Handlin� (Only mail-in applications) $ - -��
4. TOTAL PERMIT FEE (add lines 1-3 above) $ �� J� �'
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: -'�.'�G�v�- � Date: /( � �^ � C'/
DATE TIME
CITY OF ORONO CALLED IN II`�"��0 Z f �
INSPECTION OTICE SCHEDULED /- oa �
PERMIT NO. �� 3 Z3� COMPLETED l " �C�
ADDRESS �g�S Shnd�cv�tic�' �
OWNER �COSPk CONTR. �� �`n �-1��C;
TELEPHONE NO. �I�" ��� I
� DESCRIPTION S�wC�' Hac�k�
l� 01 FOOTING 11 tviECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12�E -UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-�� 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPkAINT
J 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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W� �!WORK SATISFACTORY:PROCEED ; PROJECT COMPLETE
W �❑ CORRECT WORK 8 PROCEED ! ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR ` CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call tor the next inspection 24 hours in advance. 249-46��
OwnerlContra r on site:
Inspector.Gi!/«��� CiC�-�J� �
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