HomeMy WebLinkAbout2004-P07287 - sewer connect � PERMIT
CITY��JF ORONO Permit Number:
2750 ;'ellE�"r�arkway - PO Box 66 P07287
Crysta�Bay, Minnesota 55323 Permit Type: sewer and Water Permit
(952) 249-4600 Date Issued: 3isi2oo4
SITE ADDRESS: 1489 Shoreline Dr
Wayzata,MN 55391
P I D: 11-117-23-23-0009
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: PermitFee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Thompson Plumbing OWNER: Raymond&Nylene Newkirk
15001 Minnetonka Ind.Rd. 1489 Shoreline Dr
Minnetonka,MN 55345 Wayzata MN 55391
TI�UNDERSIGNID HQtEBY REQUESTS PIItMISSION TO MAKE THE REAI,IlVIPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MTNNESOTA BUII.DING CODE REQiJIRF.MENTS.
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AP I A� PERMITEE NATURE ISSU DBYSIGNATURE
Copies: 1-File(Sienitures Reauired). 1-Aoplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Doc-04-2001 12:44pm Fram-CITY OF ORONO +pg2Z464616 T-297 P.001/001 F-306
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CITY OF ORONO A.PPL��ATION FQR LTTILITY PE�tMTTS
r �Box 66(2750 I{alley Parkway) SEWEIt/WATER
Crystal Say,MN 55323
GENE1tA�iNFORMATYON
1, Yau may spply for utility permits by rnail or u►person at the City a�ces.
2, Mailed ia applications are subject to the postage and handlit�fee shown below. Perrnet ce�rds will be sent by
return mni!th�same rlay the appli�ation is rec�;ived.
3, Permits are nat vAlid until yon raceive a pe►mit card.
4, �Vork must not begin unless the pernut eard is available an the job site.
S. Citiliry connectian permits may be issued to licensed contrsictors only.
6, ContAck the Public Works Departmeat (45?-249-4b00} for utiliry stub as-bailt locations. pQ NQT
EXCAYA'I'E IN ANY STREET ANA D�NC�T TAP ANY MAIN without express approval of the Public
Wttt�Dtpsrtment. Issuance of a permit doss not giant thIs apptnval.
7. AEl w�rk must be done in accor@snca with Sta�e Code recuirem�ats.
, 8. AA work meLst be inspe,ctect bEPore it is covere�1, CaII(952)249-4600.
24 haur natice reqaired.
.ra�s�r�nz�ss:r�� 9 sh o�.,Q;�.,,.� ��e..;v��
C3c�upan�y'i'yp�: '>( R�►sideniiai QCommerciai
�.D � Phone Numb�:
4Wuer's NBt�u�� 1y e..�.1 lC� r-�L o .
Mailiu��Addresa �k�� Sln�,�c- '� �✓ City:C�c-cx�o 7�r: �
Contractor'a Natp�e: �1 Pbanc Number:._9S."t-°►�'�-��1�
Mailing Address:I City:�R'�+tin.�,-�Y-�Lo�7�p: S��S
P�RMYT TYP`F
� Muni�ipal Sewer Connectian ($35.Oa per stub) $ �5, ar�____. __
1,�r�� pipe size '�- _inches; material,,,��Sch�dule 40 e.ir tested; cast iron
�""'�' SAC Charge (200Q rate$1,150.a0}must acconzpan�a]1 sewer p�scr�it applications unless prepaid.
�� r If not prepaid,a sevver conn�atian permit will�wt be issued.
Munteipal'VYAter Con tion($35. par stub) $
pipe siu inc s; m erial �copper; o
WATER METERS must bc p' ked p and pai�t for at City 1
Water meter� must bc sct an aied by (lrono Water artmcnt (952-?.49-d600) upon
compledon of inettr Last�llati .
RE(�UT�D minim setb from drain d and septic =7S'
REQC�rRE'D setbae �om sewcr e=2
PFBl���'�F�F�LbTi41Y
l. 3ubtota;of abovc��it:�qw�stcd * 3 S� Plt�„�
2. State Surc�tc $ .SO
'Ibe 5tata Buiiding Codc Divisinn Surcharga oi'S.SO per permit must be
includad for each wali,sewer and water conncc tion permit rcqu�stccl.
3. �asta_ge&�a.ndli��(Qrily mail-in app]ications) $__ �� _.
4. TQTAL PERMIT FEE(add linas 1-3 above) $ 3S. SZ�
Tbe undersigned hereby applies to#he City of t�rona for issuance af a Utility P�rmit, agrces to do
all work in sCiet �ecorciu'ice with thc ordinarn.es of the City and the regulations of th� Stat� of
Muincsata,and certifies that all statememts ma�le on this�applicxtion are eamplete,true and correct.
Signature of Applican�iGl�/!'LOI. �,�GP/1'�.rn Dafie: � -o -d