HomeMy WebLinkAbout2001-P04333 - sewer connect � �' PERMIT
CITY OF ORO O
2750 Kelley Parkway- P Box 66 Permit Nu b2�: P04333
Crystal Bay, Minnesota 55 23 Pe�mit Typ : Sewer and water Permit
(952) 249-4600 Date Issue : 9�i2�2ooi
SITE ADDRESS: 214�0 Shevlin Dr
WA'YZATA,MN 55391
P ID: 03-117-23-34-0021
DESCRIPTION:
Proposed Use: Residenti
Permit Class: General
Permit Type: Sewer an Water Permit Permit Sub-type(s): Sewer Connection
DETAILS: ;
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit ee: $ 35.00 Valuation: $ 0.00
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State S�rcharge Fee: $ 0.50
SAC F�e: $ 1,150.00
TOTAII,FEE: $ 1,185.50
APPLICANT• Ritter Excavat'I g OWNE ; J H SAGEHORN
� 7120 Vernon S eet 2140 SHEVLIN DR
Rockford,MN 55373 WAYZATA MN 55391
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TI�UNDERSIGNID HEREBY XtEQUFSTS PERNIISSION TO MAKE T REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WOEkI�IN STRICT COMPLIANCE WITH AL CITY OF ORONO ORDINANCFS AND
STATE OF MINNESOTA BUII.,DI[NG CODE REQUIREMENTS.
C�
I D BY SIGNATURE
Copies: 1-File(Signitures Required)>1-A�licarrt, 1-MonthlyReports,1-Asse sing, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER �� y 3 ��
Crystal Bay, MN 55323 �
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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 postaje and handling fees 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.
�. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Deparhnent(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. Ca11249-4600.
(�G24 hour notice required.
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JOB SITE ADDRESS: � l C� D r �- ��-�—�
Occupancy Type: � Residential Commercial
O�vner's Name: �ic-� -.�•-�- Phone Number:
�Iailing Address. 2/G G' �� City: � - Zip: S�9
Contractor's Name: vr�,. ��,N.� Phone Number:7� � � 77 5��f�
Nlailing Address: �/y o �/_�.,-.L.��-- City: Zip:_5��73
PERNIIT TYPE o
�Iunicipal Sewer Connection ($35.00 per stub) $����-
pipe size �� inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
1lunicipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
`VATER METERS must be picked up and paid for at City Hall.
�Vater meters must be set and sealed by Orono Water Department(249-4600)upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield�nd septic tanks= 75'
REQUIRED setback from sewer line =20'
PERMIT FEE CALCULATION � �
1. Subtotal of above permit requested $ ��- a �
2. State Surchar�e $ .50
The State Building Code Division Surchar�e of$.50 per permit must be
included for each well,sewer and water connection permit requested.
;. PostaQe & Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $ 3��c'
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all ���ork in strict accordance with the ordinances of the City and the regulations of the State of
��linnesota, and certifies that all statements made on this application aze complete,true and correct.
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Signature of Applicant:��./���.��- ��- Date: � — f� -C'/
�► � I
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION OOTIC\��� SCHEDULED �
PERMIT NO. '��� COMPLETED q�I � �
ADDRESS
OWNER a���'� S�e� (`^ CONTR. ��
TELEPHONE N0.
� DESCRIPTION ��►�'�r ����Q(�� +
l� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
y02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N,�ETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTI�N
Q OS FINAL 4C�WER 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
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS: ��� ��S � � ( ��
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W� ❑WORK SATISFACTORY:PROCEED � i�'PROJECT PLETE
W ❑CORRECT WORK&PROCEED ❑TSSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENt
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspec�n 24 hours in advance. (952� 249-46��
OwnerlContract on site: �
Inspector. � �__��'��
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