HomeMy WebLinkAbout1994-006307 - water connect .�.
PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: `�''��`��'` :' �'``�:? �''�
Orono, MirSnesota 55356-0815 Date Issued: t=�r 1�����l���
(612) 473-7357 t-�;�:#�'�•''��
SITE ADDRESS:
�.___.�._ -��f�i'�+�i.�zr�i���� ��
L��S
. _. . �'�� . . _ . �. _.- -_.._: '�'-`- ��f di:�.
DESCRIPTION:
t���"fE�; t�:��.i��P�l��::T I#����I
°:;�_w��3� �� ;��t.W3� r`���fttl�• Ty��t= f�l�tTE�; �L:��t�l�l��':�TIF��;���< .�
'=�C:.��it�i� :'-, iJ�1..Y�- W�=�i�EC I y��,�� F-i�'_�j[t�['t��:�
i`7�'r i�C fi�ti u�
tT! 1 C! 411Cl�•C
REMARKS: �;t��,�t-c �t�r„zr
t 1!T!T�'�![L•L. L'1 ! 11.rL
1 Ji�Jt'd171yfV�Y �
i�l L76�� YJ1NV
I:+•:'�'':!f}!t!if� +'{
� 1 tiit V V V\•V �"
FEE SUMMARY: ��T !��
V1 VL1L •JV �
i'r.i�t�e' Ti 7� 5it
� M•!tLLrt�[+ !L }� �.4.':JV
ljSLLLl! T 1 7 JI7 Tf, 111,rl3u
n:��f:;ti: �;;�:� ;v� T���'L�'
.i- if'virti:i�:,
�_�.-�_� I�?�•,= �;=� .�yr� .,�.v.�.-.
'=.f�ii�rj`�ctt��=�=` _______ �s..s;i3
i{�t.�:z ���:� +Y:-�; . �,i f
�.
CONTRACTOR: -- N:--�:=�? v �=�j�-��. - OWNER:
. . .__.,...... . _.__._. . t'S �•t��14•�s �u , _•i,�'��' . .'-.�I•.i.._.-•t'{ �°s J.i.�':f-��E}
`3:t�� �� �;�i��°r L=_ " '=�F-i�f�����ii i�_ij� ��`,
�fn•.-:� n t,:�,; -_:�:•.��_,�: �-it i- t c c-
�4:..ATr, - ,,:€ :, .,........ _ �,i�;t�,�wi.i F�it� ._...,:;.-�f
. ._ . _ . __. - -
: :_ : : . ,; ,: . ._.=
:1
: . ; ..��.z. ' 'iL�, x.. ;_ . _.: , ,�„',- ;,'s �-t'�,i� `r L "; t f >i�`•�z:`;- _ '; __ ,�. r�f(��
: : • ;.
•`:' :� � .., ... + _..
. :.
_ ,_. < � � ;:
_ , . ._ . . _ . ._. . .._. . . ._. . _ .__. . . _.
. ,.,. � _ , ��3 i;,1 : _ - "iJi ;��i'i �ii 1 t,rt_: t `° � � -- . z74� ��'� � �' r S ti` �-}�
�,_.r- � � - • �.:
�„;
,.- _. ...__ : . ...__:..: . ..�n...: . , s� .,....._.�...� . �._: ..+,._, , :�..__._ :�. _i'. �_ . . ._. ._ . .. .... .. ..� . ._.._ . . . __..� � _ 3 _
r�;,
:
' _.�i�F.�:. . ;_ . ,� ...�._, y , i;.7-.ir_. -
il�:: I;�ra s _�: .Y!�.�LF �x _, •�., i_:. �'i� i�; _ .. . . _ _ _ __;3�,. i,-t _,i_f()`- ;$.f ; r+,r_• �
.� :� ��. _.�����S i�:1 i�E i ? 3 �i i �.
» . .... ._ . ,. .. . . � � ....� � .., � i +�+ .
. '—`
� ... .�._... _. _ ... ... ... ... �
�
/�/ `
PLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �w� �
. - � . . . . . . . . . . . .._ .. ..._.... . . N
... .' ''".... ........... . . . . . . .
"_... . .. .... �;
* CITY OF ORONO APPLICATION FOR UTILITY PERMITS ���C� ? �
- ' Box 66 (2750 Kelley Parkway) SEWER/WATER
Crys�al 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 retum 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 cazd is available on the job site.
5. Utility connection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Department(473-7357)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 ,r
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 473-7357.
24 hour notice required.
JOB SITE ADDRESS:
� z-C�-G� ,��'1
Occupancy Type: � �� Residential Commercial �
Owner's Name: ����
Phone Number: '�-/ 7/- � ��L'
Mailing Address• _ -T�' City: C`!���c: �P:
Contractor's Name: ,C �- �/ ' -�, PhoneNumber:
G
Mailing Address: City�ti�ll.� Tp: �` J :
����
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) �
pipe size inches; material PVC (on sand fill); cast iron
SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
� c� �
Municipal Water Connection ($35.00 per stub) $ �� T�
pipe size / inches; material copper; other "
WATER METERS must be picked up and paid for at City Ha1L
(5/8 meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department (473-735'n upon
completion of ineter installation.
REQUIRED minunum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested �
2. State Surchar�e $ .50
The State Building Code Division Surchazge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta�e & 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 °
conect.
Signaturc of Applicant•
� z�� L�Lz---��iyz.._--� Dare: �� r' 9 .
DATE TIME
CITY OF ORONO CALLED IN ���' y
INSPECTION NOTICE SCHEDULED �'< «� ��
PERMIT NO. Co 3 d� COMPLETED 1( K
ADDRESS. � -�3�' *��?rt- .�L`'`�-Cd
OWNER /��� CONTR. �2 '�L�C��z
TELEPHONENO. � �� ' ��� � l �� DCrdes.�1
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOO - 34 TREE REMOVAL
Q 05 FINAL 13 N ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS•
� � Ur ��t, �e.v� �
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
O
��WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ; ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
OwnerlContra n e:
Inspector. �
White Copyllnspector's Fil Canary CopylSite Notice