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Home My WebLink About2004-P08234 - sewer connect � � CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Pos234 Crystal Bay, Minnesota 55323 Pet'mit Type: Sewer and Water Permit (952) 249-4600 Date Issued: 1ii29i2oo4 SITE ADDRESS: 2145 Shevlin Dr Wayzata,MN 55391 P I D: 03-117-2 3-3 4-0005 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 SAC Fee: $ 1,350.00 TOTAL FEE: $ 1,385.50 APPLICANT: Atco Utility Services OWNER: �'�'ILLIAM M TOLES 3660 County Rd/ 101 S 2145 SHEVLIN DR Minnetonka,MN 55391 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. c / � ,'�� l� �'',,'-, , _'�?�Z�� c.. � '/ � -- -� AP N EE GNATURE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required). 1-Applicant, 1-Monthlv Reports. 1-AssessinE. 1-Finance Page 1 � � � (Updated 1/5/04) CITY OF ORONO APPLICATIOP�t FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC Crystal 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 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 perniit card is available on the job site. 5. Utility connection pemuts 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 Deparhnent. Issuance of a pemrit 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: � �' c(/��N Occupancy Type: Residential Commercial Owner's Name: �i`� ,ti r��s Phone Number: �JJ'�a' ?ys— ?��7 Mailing Address: a/�S �(jG(/L!N 1Z. City: L�6Zvy�/z� Zip: S,�9/ Contractor's Name: ��71'� t.��,��« �o�.c,� Phone Number: it'e�-� y�3'"7o2y� Mailing Address:_,�� . �Q /�/ City: �J;�,¢ Zip: �j 3i/ . PERMIT TYPE �Connections ❑Repairs ❑Dis�onnect (Check One) SAC Charge (2003 rate $1,350.00) $ (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) $ 3�`aa pipe size `� inches; material � Schd 40 air tested; cast iron Municipal Water Connection/Disconnect/Repair($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. REQUlRED minimum setbacks from drain field and septic tanks = 75' REQUIRED setback from sewer line=20' PERMIT FEE CALCULATION l. Subtotal of above permit requested $ 2. State Surchar�e $ .50 (Minimum) The State Building Code Division Surcharge of$.50 per pernut must be included for each well,sewer and water connection permit requested. 3. Postage & Handlin� (Only mail-in applications) I $ 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: Date: // a9 �y �� l � (Llpdated 1/5/04) CITY OF ORONO APPLICATIO FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC Crystal Bay, MN 55323 GENERAL INFORMATION 1. You may apply for utility pernvts 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 joi�site. 5. Utility connection pernuts may be issued to licensed contractors only. 6. Contact the Public Warks 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 Deparhnent. 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: � (`"�� vl-r�v�� i V�- �J►' i��.-- Occupancy Type: � Residential Commercial Owner's Name: � � � Phone Number: ��j Z '"(�Gj '�y�� Mailing Address:_�_I Q-G� _S h c;c,� f� n k-�I � City: � 2 Zip: F 3 Contractor's Name: -A-'(�� Phone Nu ber: Mailing Address: City: Zip: .-� PERMIT TYPE �Connections ❑Repairs ❑Disconnect (Check One) � �c� SAC Charge (2003 rate $1,350.00) $ C �j�-�3� (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) $ 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' REQUlRED 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 pernut must be included for each well,sewer and water connection pernut requested. 3. Postage &Handling (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 issua�ce of a Utility Permit, agrees to do all work in strict accordance with the o inances of th City and the regulations of the State of Minnesota, and certifies that all statements made on this applica 'on ar�e com ete, e and correct. �e�`;7 Signature of Applicant: �''" ' - -• � Date: I � 2�t � ��_ .- �� I ✓ � DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT N0. p��Z3`� COMPLETED -�6�y :� ADDRESS 4� 1`��^ OWNER ; CONTR. 's � � TELEPHONE NO. � DESCRIPTION �`�� d� v' � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ ADING/FILLING Q 02 FRAMING 13�ECHANICAL FINAL 19 LAKESH RE/WETLANDS y 03 INSULATION 24/ 5 WOOD BURNER/FIREPLACE 34 TREE RE OVAL Z 04 WALL BD. 12 �VATER HOOK-UP 17 SITE INS ECTION Q OS FINAL 14 EWER HOOK-UP 06 PROGRE S � 07 DEMO-SITE 27 EPTIC MAINT. 21 COMPLAI T � 07 DEMO-FINAL 15 EPTIC INSTALL. 22 FOLLOW- P i09 PLUMBING RI 23 $EPTIC FINAL 35 HARD C ER REMOVAL J 10 PLUMBING FINA� 36 FOUNDA ON/REMOVAL � OWNERICONTRACTOR TO MEET YOU:.�S(ES_NO v�, COMMENTS: a ' � c, t �r- �r �V e: .�_ � "' ��? �.�^ �:Q ^ .-, rr O � � � �` " ,� `l � _ rt__ � �''; .;�,.. � i G 1� f � - r�-�.�. .:,,�" �.--- Q � a W � W � � � `6j,�VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W �❑ZORRECT WORK 8 PROCEED_ ❑ ISSUE CERTIFICATE O OCCUPANCY � ❑CORRECT WORK,CALL FOR REIN$PECTION TEMPORA V BEFORECOVERING PERMANE T ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO pRRANGE ACCESS. Call for the next insp�ction 24 hours in advance. (g52) 2 9-46�� Owner/ContXactor on site� Inspector. �;�~" r} rt � 5� '. Whiie Copylinspector's File Canary CopylSite Notice ✓ DATE TIME CITY OF ORONO CALLEO IN INSPECTION NOTIC SCHEDULED PERMIT NO. �D$�3 �F COMPLETED IZ Z.Z-c� ADDRESS �y S��-`'��` � � OWNER CONTR. �` � TELEPHONE NO. � DESCRIPTION S�w �»T �0 — �1 � 01 FOOTING 11 jMECHANICAL RI 18 EXCAV/ DING/FILLING Q 02 FRAMING 13 ECHANICAL FINAL 19 LAKESH RE/WETLANDS y 03 INSULATION 24/ 5 WOOD BURNER/FIREPLACE 34 TREE RE OVAL Z04 WAIL BD. 12 ATER HOOK-UP 17 SITE INS ECTION Q OS FINAL 4 EWER HOOK-UP 06 PROGRE S � 07 DEMO-SITE EPTIC MAINT. 21 COMPLAI T � 07 DEMO-FINAL 15 PTIC INSTALL. 22 FOLLOW- P = 09 PLUMBING RI 23 EPTIC FINAL 35 HARD CO ER REMOVAL v 10 PLUMBING FINAL � 36 FOUNDAT N/REMOVAL � OWNER/CONTRACTOR TO MEEf YO�I:�(SfES_NO c�n COMMENTS: a ' a�� - k 1 a5 �.�r .S ! � 1�r , 0 �. _ � 0 � W � Q � z W � W � . � � � ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE � W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF CCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORAR V BEFORECOVERING PERMANEN ❑CORRECT UNSAFE CONDITION WITFIIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPEGTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspe¢tion 24 hours in advance. �95Z� Z4 -46�� OwnerlContr or on site: Inspector. c�"`�`r�' White Copyllnspector's Filb Canary CopylSite Notice