HomeMy WebLinkAbout2001-P04555 - sewer/water disconnect PERMIT
CI�� OF ORONO
2;�0 Kelley Parkway - PO Box 66 Permit Number: Po4sss
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: 10�26�2ooi
SITE ADDRESS: 2200 Shadywood Rd
WAYZATA,MN 55391
P I D: 17-117-23-42-0006
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Sub-type(s): Sewer&Water Disconnecti
Permit Type: Sewer and Water Permit
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Coppin Plumbing OWNER: V W YOUNG ETAL
5089 Shoreline Dr 2200 SHADYWOOD RD
Mound, MN 55364 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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APPL CANT P EE SIGNATURE UED BY SIGNATi JRE
Copies: 1-File(Signitures Reguired), 1-Applicant, 1-MonthlyReports,1-Assessing, 1-Finance Page 1
(iJr:iated 2/12/O1)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
�x 66 (2750 Kelley Parkway) SEWER/WATER C
� Crystal Bay, MN 55323 � �i �J
GENERAL INFORMATION
1. You may apply for utility permits by mail or in person at the City offices.
2. Mailed in applications aze 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 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.
?. 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: c� �6 O S I�C�.c� u�l� cI � �
Occupancy Type: Residential Commercial
Owner's Name: Phone Number:
Mailing Address: City: 7�:
Contractor's Name: �„`�,��� �'o ,p ,�,in Phone Number:� 5�.-�j ��- �-3 ► b
Mailing Address: �o z��1 51-..o rc t �hc � ,� City: �'�,o��, �_ Zip: �5�3 i��
PERMIT TYPE .
Nlunicipal Sewer Connection ($35.00 per stub) $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00) 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.
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 jfr�n sewer line=20'
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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. PostaQe & Handlin� (Only mail-in applications) $ 1.50
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: Date:
_ _
4
��� DATE TIME
CITY OF ORONO ' cn��E�irv •
INSPECTION NOTICF�;ji��CHEDULED �
PERMIT NO. � �'��f � COMPLETED '�v
ADDRESS � � 1�-
OWNER CONTR. �7^���
TELEPHONE NO. ? ( � - �
� DESCRIPTION ��� /���.
� -
lL 01 FOOTING 11 MEC I L I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTA�L. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNER/CONTRACTOR TO MEET YOU: YES_NO
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� ❑ CORRECT WORK&PROCEED ��� ISSUE CERTIFICATE OF OCCUPANCY
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OO Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
CJ STOP ORDER POSTED.CALL INSPECTOR 1 CITATION ISSUED
[�: INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContra r on site:
�
Inspector.
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