HomeMy WebLinkAbout2008-P11889 - sewer/water disconnect PERMIT
CITY OF ORONO Permit Number:
2�f�0 Keli�y Parkway- PO Box 66 P11889
Crystal Bay, Minnesota 55323 Permit Type:
Sewer and Water Permit
(952) 249-4600 Date Issued:
2/27/2008
SITE ADDRESS: 2118 Shadywood Rd Unit#
Wayzata,MN 55391
P��� 17-117-23-42-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Pernut Permit Sub-type(s): Sewer&Water Disconnectic
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Scherber Co. LLC OWNER: Paul&Leann Hanssen
11415 Valley Dr. 2118 Shadywood Rd
Rogers,MN 55374 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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AP PERMITEE SIGNATCJRE ED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, I-Septic) Page 1
� FOR CITY USE ONLY
O¢D�O City of Orono Date Received: Permit#
P.O.Box 66
2750 Kelley Parkway ❑In-House SAC Determination Form Completed
� �'.►�. ; Crystal Bay,MN 55323
' �.;`o (952)249-4600 Approved By(If Required):
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CITY OF ORONO—SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Of�icial and/or Public Works Uepartment*)
(ALL PERMITS- Mav be subiect to further review and mav not be issued when t6e aaalication is mceived)
GENERAL INFORMATION
I. 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 fee shown below. Permit cards will
be sent by return mail within 2 business days.
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 connection permits 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 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. Call(952)249-4600,24+hour notice required.
TYPE OF PERMIT
Check All That A 1
� Residential(May Require Approval) ❑ Commercial(Approval Required)
� New Connection ❑Additional Connection �Re-Connection � Repairs Q✓ Disconnect
Job Site/Owner Information:
Site Address: 2118 Shadywood Rd
Owner:
Longmann Builders Mailing Address: 9401 Creston Place
City: Eden Praire Zlp; 55347
Home Phone: �612) 801-0526 Alternate Phone:
Contractor Information:
Contractor: Scherber Co LLC Contact Person: Corey
Address: 11415 valley dr State License#: RLI 612074
rogers 55374 01-01-09
City: Zip: Expiration Date:
(763)497-1100 (612) 282-7403
Phone: Alternate Phone:
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DETERMINING PERMIT FEES
� SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
� Sewer Connection/Disconnect/Repair($35.00/Per Stub) �
Pipe size inches;material Schd 40 air tested; 0 cast iron
0 Water Connection/Disconnect/Repair($35.00/Per Stub� $
Pipe size inches;material Schd 40 air tested; copper
l. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
ADDITIONAL INFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
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,true and correct.
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Applicant: Date: � � � r ` ��
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