HomeMy WebLinkAbout2003-P05934 - sewer repair " '� PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: pos93a
Crystal Bay, Minnesota 55323 Pe►'mit Type: Sewer and water Permit
(952) 249-4600 Date Issued: 1i3i2oo3
SITE ADDRESS: 1300 Shoreline Dr
Wayzata,MN 55391
P I D: 02-117-23-31-0018
DESCRI PTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Sewer and Water Pernut Pernut 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: Genes Water&Sewer OWNER: Robert&Barbara Howard
P.O.Box 18526 1300 Shoreline Dr
4360 Lyndale Ave N Wayzata MN 55391
Minneapolis,MN 55418
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.
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AP ANT RMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Aunlicant 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
(iJpdated 5/3/02)
CIT�' O�-JJRONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORMATION
i. 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. Pernut 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.
5. Utility connection pernuts 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.
JOB SITE ADDRESS: i`.S�v c S�/�re � : .��e �,.,
Occupancy Type: >' Residential Commercial
Owner's Name: Phone Number:
Mailing Address: City: Zip:
Contractor's Name: �2ho; �JH�- � �..Q,s Phone Number: �8� - 3�37
Mailing Address: �/�ao �J�tc /i,,e r.,fu . City: ✓��, ,; Zip: ,�-�{�'L
PERMIT TYPE ❑Connections �'Repairs ❑Disconnect (Check One)
SAC Charge (2002 rate $1,200.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
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Municipal Sewer Connection/Disconne t/Repair 5.00 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'
REQUIRED 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 permit requested.
3. PostaQe &Handlin� (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 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 com nd correct.
Signature of Applicant: Date: � - 3- ��-
FEB.24.2004 7�56AM JNBA FINANCIAL N0.890 P.1i2
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PHE BLOHNN�BVINKET 6PECIALIST CENtTRqL SYSTEMS LLC
3e�'�^'�' CENTRAL INSULATION
NAGOMA.MN 55387 ��,���gP��
;652144�-2�92 OFFICE 9895 NWY.2E�
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Project name BRAl1N� RICHARD i �5,
1300 SHORELINE pRNE c�"—" . � l./`•
ORONO
MN 55391
GliQrit RICHARD BRAL7N
1300 SHORELINE DRNE
ORONO �/���,)=ZCl��
MN 55391
� Estima't�r I,ARRY J.PLOCH�R
Bid dabe Z/23/2004
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We egree to do above ma rk for e price o1�2,168 dellars
Sipnature ' � S�nature _
2P2312004 ' Date
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DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION N CE _ SCHEDULED /-�-,�
PERMIT NO. ` ,3� COMPL�TED
ADDRESS � �X1 /P� ��
OWNER CONTR. �c'_ �%� S ��� � �'�•
TELEPHONE NO. _ f� �� :.��Q c��l�� ��`� _
� DESCRIPTION �S(J.t.�"�� ,���Gt�2-
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER 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:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CAL�FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR
❑CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the ne t inspection 24 hours in advance. (952� 249-4600
OwnerlConU o ite:
Inspector. -�
White Copyllnspector's e Canary Copy/Site NoUce