HomeMy WebLinkAbout2001-P03508 - sewer connect ' � a PERMIT
C�TY OF ORONO
Permit Number:
2750 Kelley Parkway- QO Box 66 Po3soa
Crystal Bay, Minnesota�55323 Permit Type: sewer and Water Permit
(952) 249-4600 I Date Issued: 2�6�2ooi
SITE ADDRESS: 2170 hevlin Dr
WAY ATA,MN 55391
P 1 D: 03-117-23-34-0018
DESCRIPTION:
Proposed Use: Reside�tial
Permit Class: General
Permit T e: Sewer�nd Water Permit Permit Sub-type(s): Sewer Connection
YP SAC Only
DETAILS:
Approved per resolution#:
Sepazate permits required:
i
i
NOTICES/REMARKS:
,
�,
FEE SUIIAMARY: Per it Fee: $ 35.00 Valuation: $ 0.00
;
State Surcharge Fee: $ 0.50
SAC Fee: $ 1,150.00
TOT L FEE: $ 1,185.50
APPLICANT: �TTER EX AVATING OWNER: R P WIENS&J A WIENS
7120 VERN N STREET 2170 SHEVLIN DR
. ROCKFORD�MN 55373 WAYZATA MN 55391
THE UNDERSIGNID HEREB�REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL W RK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII�DING CODE REQUIREMENTS.
'l..�C.__ �7�C Q•�f�
ISS BY SIGNATURE
Copies:City,Applicant,Assessor,Finance Page 1
�!
� CITY OF ORONO APPLICATION FOR UTILITY PERMITS
r
; Box 66 (2750 Kelley Parkway) SEWER/WATER �0
Crystal Bay,MN 5�323 °�
D
� GEI�TERAL 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 return mail the same day the application is received.
;. 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(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 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 249-4600.
24 hour notice required.
JOB SITE ADDRESS: Z � �C� // �,��-�-�'L 1�'z
Occupancy Type: _ � Residential Commercial
Owner's Name: C; �� " -c� � Phone Number: 9s7- Lf �3- �9%�
i�lailing Address: G �. � City: /�� , Zip:
Contractor's Name: ti� /��,. ���/'-�-� Phone Num er: 7�,� L�;� S'(��
Nlailing Address:�/7 n y'/�-t���z �1�f City��- ,-,-C Zip: S--S-37��
PERNIIT TYPE
i�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.
�Tunicipal `Vater Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER 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 and septic tanks = 75'
REQUIRED setback from sewer line=20' .
PERIVIIT FEE CALCULATION .
1. Subtotal of above permit requested $
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.
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.
/�
Signature of Applicant: �� -��-L Date: ,���� "J��
� I�
� '
� , �
; . � _
�
_r
�It}` ��; Q^,_;'r;C�
.��, r- r
�'^5„-}jj.`S �� `;1!.' rr..-.—.
f,^,- >. ' ; J.:_�.L�
..��,�i,�_.•?h.�
. � , '�O'.;�
n`�;;:S/':�- 1�:�_
.r.__
� t.'1SfC(i @'r': �'(i_e"r�
�<<u1Ts GE�ticR�l
c.:�_ �ee t - ._. ;;a���,
�'l::i; i-'.:_:';=s! `_'. . �:i.i:,r:,
. I *G
1 ff `�i1
. - ;'�1I1 Ifl fL'�'`� .'.:1%1 .
6
�L i r ,;,,_,�, _ ,
�a=:: :u:-c,;.�ry_ =r,,,`,
,.,n n�_. i C� ��,;:� -
-- L�,�r--a �'.�.
L'�','-��i���1tl_ �i-'�J.:�(� i 1:�G,r'iO
i; —
�� _ _
' • .,�'i, (i,fJ(1
n�;r���T^�
TAi• I�1�J�4II
�n�rr , r.�,Lr �'.i:(1
'- Zi [
Ca�h Rec �;=�35.��;
eived
�
Ghe�_k Rzc=�:_�� �� t�•�:,
�..�",,c?
Cf�P.h'6�
[�rH�` U.i�i�
C�G,�fii1 ��i T 4'Yf'kiN 1:i_�C�
,
DATE TIME �
CI�Y OF ORONO CALLED IN ���� /��3a
INSPECTION N�TI�E 6� SCHEOULED - - V� ���•�--
PE�iMIT NO. U , �� COMPLETED �� � /
ADbRESS �
OWINER V�/ �� CONTR. ��-
TEI�EPHONE NO. �Jr.� — �-{ 73 — � �Y�
� DESICRIPTION
lV 01 F(�OTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRYIMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 03 IN3ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 W L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FIN L SEWER HOOK- 06 PROGRESS
� 07 DE O-SITE . 21 COMPLAINT
� 07 DEN10-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PU�VIBING FINAL 36 FOUNDATION/REMOVAL
� OWNE CONTRACTOR TO MEET YOU:_YES_NO
� COM�ENTS:
�
a �� �� ���
j �
O
�" , - - _
�
, -�.
O '
� �
W
� � G,�Gt�
Q
� I
2 '
W
�
W
� I
�
� �WORK ATISFACTORY:PROCEED �PROJECT COMPLETE
W CORR CT WORK&PROCEED C; ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORR T WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOR COVERING PERMANENT
❑CORRE�TUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
IN�PECTOR WILL RETURN r CITATION ISSUED
❑STOP OpDER POSTED.CALL INSPECTOR
❑ INSPEC�ION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlCb tr or on site:
Inspect � ��[,,��a,vy S'
' White Copyllnspector's File Canary CopylSite Notice