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Home My WebLink About2002-P05193 - water connect CITY OF ORONO PERMIT 2750 Kel�y Parkway - PO Box 66 Permit Number: P05193 Crys�al�E�ay, Minnesota 55323 Permit Type: seWer ana wacer Pe�c (952) 249-4600 Date Issued: s�2o�2002 SITE ADDRESS: 2500 Shadywood Rd Excelsior,MN 55331 PID: 2ai i�-23-i i-oo34 DESCRIPTION: Proposed Use: Institutional Pernut Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Water Connection DETAILS: Approved per resolurion#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: Widmer Inc. OWNER: Freshwater Foundation Box 219 2500 Shaydwood Rd St.Boni,MN 55375 Excelsior MN 55331 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � � �--�-..�-� �....�� - ��_. `�-�� -� �, � �, APPLICANT PERMITEE SIGNATURE I UED BY SIGNATURG Copies: 1-File(SiQnitures Repuired), 1-Applicant, 1-Monthlv Reoorts, 1-Assessin�, 1-Finance Page 1 (Updated 5/3/02) CITY OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC Crystal Bay�MN 55323 J 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. 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 pernut card is available on the job site. 5. Utility connection pernuts 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 pernut 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. JOB SITE ADDRESS: �S�''J S'�ffc-Cr c�/.�e,� �`L�� , Occupancy Type: Residential �'— Commercial Owner's Name: �,��ss� c��¢.'z� �<�c• �f.%� Phone Number: Mailing Address: �S'��D �Sh��/4 ��,k �'c:� City:c1.��•��1 Zip: S�s":3s'/ Contractor's Name: t,cJ:��l�� t�c_ Phone Number: �s-��-- Ys,i�,/y�'S-s- Mailing Address: �� .��,_ �=�,,�� City:.S,:��:�,-��,�•;Zip: �J�3�j�' PERMIT TYPE �nnections ❑Repairs ❑Disconnect (Check One) SAC Charge (2002 rate $1,200.00) $ (Set Rate) Sac Charge must accompany all sewer permit applications unless prepaid. (If not prepaid, a sewer connection will not be issued) Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $ pipe size inches; material Schd 40 air tested; cast iron Municipal Water Connection/Disconnect/Repair($35.00 per stub) $ �J �� pipe size� `� inches; material copper; other 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 tanks= 75' REQUIRED setback from sewer line=20' PERMIT FEE CALCULATION 1. Subtotal of above permit requested $ 2. State Surchar�e $ .50 (Minimum) The State Building Code Division Surcharge of$.50 per permit must be included for each well,sewer and water connection pemut requested. 3. PostaQe &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 this application are complete, true and correct. Signature of Applicant „/,.,� ��sc.�.Z�-,�Q Date: -s � -o,� i �� DATE �[ME CITY OF ORONO � CALLEDIN INSPECTION NOTICE SCHEDULED �_IT�c7 PERMIT N0._ PC�b--1�� COMPLETED 5 —.�"a� Z:� C� ADDRESS_ �`=�� '��-Wt v00 t`� OWNER CONTR. �"��IC��Y O,_,�'1 TELEPHON E NO. !"��J a �`1 �l('--( l� / ej ' � DESCRIPTION I Q �-��-� � � � Ot FOOTING 11 MECHANICAL RI y 18 EXCA�//GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP � 09 PLUMSING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU�YES_NO � MENTS: �C` S � /�" � ., f a ' ' /`�, ' .--�Y�:.M, . � J O � � O � W � Q � 2 W � W � � W� �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP OFDER POSTED.CALL INSPECTOR O INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46�� Owner/Con�ractor on sit • Inspector., �� -' t�� , White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN / INSPECTION TICE SCHEDULED PERMIT N0. COMPLETED � z— Z'3� ADDRESS cS G✓ OWNER CONTR. TELEPHONE N0. � � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILUNG Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL O � � W�B�• AT - 17 SITE INSPECTION 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 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 2 OWNERIC CTOR TO MEET YOU:_YES_NO v�, COMMENTS: a �� j 0 �, � 0 � W � Q � Z W � W � j � ORKSATISFACTORY:PROCEED �iOJE COMPLETE W �CORRECT WORK 8 PROCEED � ISSUE ERTIFICATE OF OCCUPANCY � O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITIONWITNIN HOURS. p pH OTAKEN INSPECTOR WILL AETURN ❑CI TION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on si • Inspector. /�% White CopyMspector's File Canary Copy/Site Notice V DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI E J(l �j SCHEDUIED � � • .� � PERMIT N0. COMPLETED ADDRESS � OWNER CON . � �� TELEPHONE - � DESCRIPTIO C�••�(..��-�-� �`�'�" � � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 77 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 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 � OWNER/CONTRACTOFiTOMEETYOU• YES_NO � CO� ME �S: � � , j � O � �. • � � ' �''� �) �'S3�r W � � Q � Z W � W � � d W,�WORK SATISFACTORY:PROCEED �AROJECT COMPLETE �� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN INSPECTOR W{LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-46�0 OwnerlContractor on site- Inspector.�/��'li �il�- White Copyllnspector's Ffle Canary Copy/Sile Notice