HomeMy WebLinkAbout2008-P11875 - sewer repair PERMIT
CITY OF ORONO
27�50 Kw:�ey Parkway- PO Box 66 Permit Number: p11875
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
2/14/2008
SITE ADDRESS: 2795 Shadywood Rd Unit#
Excelsior,MN 55331
PID: 21-117-23-31-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Pernut Permit Sub-type(s): Sewer Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Roto Rooter Services Co. OWNER: S R&P A Beck
14530 27th Ave.N. 2795 Shadywood Rd
Minneapolis,MN 55447 Excelsior MN 55331
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 BU LDING CODE REQUIREMENTS.
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APP ICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
FOR CTLY USE ONLY '
O„���0 City of Orono Date Received: Permit#
P.O.Box 66
` 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
�3, ��,.� Crystal Bay,MN 55323
�7� (952)249-4600 ApprovedBy{IfRequired):
CITY OF ORONO—SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may�equire apprrnal by the Building Official and/or Public Works Department')
(ALL PERMITS- Mav be subiect to further review and mav not be issued when the agplication is received)
GENERAL 1NFORMATION :
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 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 PERIVIIT
; (Check All�"hat A 1
�Residential(May Require Approval) �Commercial(Approval Required)
�New Connection ❑Additional Connection �Re-Connection �Repairs ❑Disconnect
Job Site/0wner Information: '
Site Address: U'7�S ,S��N�, �b� /�t�
Owner: ���✓� ���� Mailing Address: ��-C
City: �/�On c� zip: SS3 3/
Home Phone: ��-`'l7(- �S/S Alternate Phone:
Contractor.Information: `
�,� /���K f,
Contractor: �� `'`D"��`" Contact Person: '✓/ � 'u
Address: �y��� ��� �/"`w State License#: ��3��/
City: � o�� Zip: S�� Expiration Date: �4,"���
Phone: 7���S�7-3�07 Alternate Phone: 7�9-T-S�g"35dQ
�SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if appiicable)
(If not prepaid,$sewer connection permit will not be issued)
�Sewer Connection/Disconnect Repair $35.00/Per Stub) $ �J.�
Pipe size inches;materia chd 40 air tested; 0 cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub $
Pipe size inches;material Schd 40 air tested; � copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines ]-3 Above) $
ADDITIONAL INFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate nermit.
■ 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 accord c ith the ordinances of the City and the regulations of the State of
Minnesota,and certifie t all statements made on this application are,true and correct.
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Applicant: �_ Date:�/ ��
� DATE TIME ,
CITY OF ORONO CALLED IN ���
INSPECTION NOQTICEp �-j SCHEDULED a� —O /:O�
PERMIT NO. / ��O 7v COMPLETED
ADDRESS a74S .S�Q�y urrr� /�-�
OWNER CONTR. .eO7� ����'V
TELEPHONE NO. 7� 3 Sl g �3�' �
� DESCRIPTION �`��-'` ��'�-�
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ,
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. (952� 249-460�
Owner►Contractor e:
Inspector.
White Copyllnspector's F Canary Copy/Site Notice