HomeMy WebLinkAbout2002-P05754 - sewer connect � � '1� ' � PERMIT
C I T'� O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Pos�s4
Crystal Bay, Minnesota 55323 Pet-mit Type: Sewer and water Permit
(952) 249-4600 Date Issued: io�23�2002
SITE ADDRESS: 1420 Shoreline Dr
Wayzata,MN 55391
PID: 1 i-i i�-23-22-oois
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Coppin Plumbing OWNER: David Feldshon
5089 Shoreline Dr 1420 Shoreline Dr.
Mound,MN 55364 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMI E SIG ATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(LTpdated 5/3/02)
CI'I`Y:OF i�►�20N0 APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for utility pernuts 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 job site.
�. 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 pemut 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: �� � a� Y1 c�� �C� O r �tih�Cy
Occupancy Type: L� Residential Commercial
Owner's Name: �e����'�.��S Phone Number: � � � �'�� ��'�'�
Mailing Address: City: Zip:
Contractor's Name: � 'U .� �'�-�'� Phone Number: S�-•c-f 7-i �-3 ( �
Mailing Address:s�$�.S�.,�c�e V-�cZ-- City: rn o���. � Zip: � '1.��
PERMIT TYPE�'�nnections ❑Repairs ❑Disconnect (Check One)
�:K
�����`: 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)
Municipal Sewer onnection/Disconnect/Re�ir($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.
R'ater meters must be set and sealed by Orono Water Department
(9�2-249-4600) 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 permit must be
included for each well,sewer and water connection pemut 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 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 ar complete, tru d correct.
Si�ature of Applican : ' Date: � � � O � C �
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OFFICIAL CHECK , �
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NOTICE TO CUSTOMERS p • AUTHORIZED SIGNATURE
as e cw+dition so mis insUnroo�':tss.aie`nd'ertniiy o�atf�idevii � y�
chaser a9rees to provide��nt�Of thie che�k���M� �.r s
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, , , From-CITY OF ORONO +9522494616 T-138 P.001/0�2 F-861
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2750 Kelley Parktir•ay
P.O Boz 66
Crystal Bcry, 1�LY >j323
. (9�2)2�9-4600 .
Fc�c: (9�Z) Z�{9-4616
FAX TRANSMISSION COVER SHEET
Date: �.,
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Se�rder: � � I`� 1~ `' � �C" ��''� � � I�� �•� � 'I .S2 -_2.-'i'� ��0� 1
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YOUSHOULD RECENE � ' PAGE(5),INCLUDI�VG THIS COYER SH,�ET.
IF YDU DO NOT R�'c:`ENF AZL THE PAGES, �•
PLEASE CA.LM(9�2) 2;�9-�600.
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pI.I,Sp,NITAity SgyyER A1�iD MUNiCIPAL WATER CONNL�iCTION CHARGES(If not previously assessed or lf sn improvement projcct is nol deemed lo be
in the snle discretlon of the City. If an improvement is required, the connection cbarge may be in addit[on to any sssessmeait.)
The connection charge for prnperlies wLsbiag to conncct to the sewer or v��ater but which are located outside the delineated boundaries of the sfPected project area ahall ,�
be chacged ihe wnnection fee Cor that area. Such co,mecllons are snbjecl to City Council approval.
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S�WF.�PROJEC� �
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1980-1 INinnetonk$Blnffs $�1685.00 1 0
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1980-1 West Rerndale/Coun Road 15 $27,140.00 � �
1980-I Orono Lsne �21715.00 1
1980-1 Coun Road 15lMarinas $9,100.00 1 c
19 - - - __cotch Pine 527,140.00 . (1)
L�ne ------�� �
1981-1 North Shore DrivelHi hwood $13 975.00 1
1982-1A Navarre Utilities S 2,9?O.UQ Truok Area (1) m
S122O.00 N
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198�1B Navsrre Utitities 11Torthern $485.00 $3,220.00 (1) �
Avenue (trunk uoit Per Acre .
acre/unit
1985-I C stai Ba $14130.00 3 .
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CRBDTi'TO AREA:
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(1) 602�37G91 Se�vcr Operattng (6} 311 37691 I997 Improvements o
(3) 310-37691 1985 Im'prove Cryslal Bsy (7� 313-37691 t998-1999 Sewer Improvements , . �
` (4j 406-3769! PIR fiu�d�d/7 LS&Forcemain (8) 3i437691 200U Sewer Improvements N
. (� 308-37691 1992 Ia►prove Stubi�s Bay ?00!Fee ScheduJe Page!0 -;
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� DATE -� TI
CITY OF ORONO �/ CALLED IN D I�ID�- ��-
INSPECTION NOTICE SCHEDULED —��';� '" -
PERMIT N0. ���1���� coMP�ErEo
ADDRESS_ __ �'� �� � �'�Y� L i t'�- �(Z
OWNER CONTR. � c`�71�15
TELEPHONE NO. �'> � � �'�ut,� — �o���-C�
� DESCRIPTION ��� '�t �I )'�( � - ���-�f�I� ���-��''E�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIILING
Q 02 fRAMING 13 MECHANICAL FINA� 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 06 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 HAFD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAI�
� OWNERICONTRACT R TO MEEf YOU:�ES_NO �
� COMMENTS: C ' ,� ' �,e�� L �,� �
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W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-460�
Owner/Contractor s' e
� � �
Inspector.
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