HomeMy WebLinkAbout1993-005844 - sewer connect PEI�MIT
CITY OF ORONO _ � PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 � Permit Number: `���:�W�' ", �r���=�`�
Orono, Minnesota 55356-0815 Date Issued: t:�i}•_�':���:� �
(612) 473-7357 ��`.''�1_/��r�
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LICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
CITY OF ORONO APPLICATION FOR UTILITY PER�iITS
Box 66 (2750 Kelley Parkway) , SE`VERJWATER
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 fees shown below. Pemut cards will be sent
by return mail the same day the application is :eceived.
3. Permits are not valid until you receive a per�iit card.
4. Work must not begin unless the pemut card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department (473-7357)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 473-7357.
24 hour notice required.
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JOB STTE ADDRESS: ��jG�%-3 �d�, /Z� '
Occupancy Type: �,�_ Residential Commercial
Owner's Na.-ne: �` "' PhoneNumber:y 7 � ._ —
Mailing Address: - ` City:y��,��� Zip: ��
Contractor's Name: PhoneNumber:2�73 —�,/3�J�
Mailing Address: �� ,� ll;�>�,� .�i�t,� City: Le._i�T��; .� 7�: i��/
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size _1-� inches; material �:� PVC (on sand fill); cast iron
SAC Charge ($750.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
�VATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department (473-735'n upon
completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per permit must be
ineiuded for each well, sewer and water connection permit requested.
3. Posta�e & Handlin� (Only mail-in applications) $ 1.SO
4. TOTAL PERMIT FEE (add lines 1-3 above) $
T'he 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 Ciry and the regulations of the State
of Minnesota, and certifies that all statements made on this application are complete, true and
correct.
� Dare: /��,�// �/� �
Signature of ApplicanG _ � . , D� - '
DATE TIME
CITY OF ORONO CALLED IN %� '��-�3
INSPECTION NOTICE SCHEDULED ��-� , l % �
PERMIT NO. S'��`� COMPLETED ��'�� ,'�.' f�' �� ��
ADDRESS / �4�D S_`1,�-�u,Le�-� �✓� -
OWNER �,�����.�-�a� CONTR. �,�-f'a'�-.�� _�, '
TELEPHONE NO. '� � 3 ' �3�' �
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICA�FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q 05 FINAL 13 M IT ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOI- O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERfCONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: 1-`��
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d �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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W " ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. Ln, PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector. ',. +:E�_..�%'���-,---
White Copy/inspector's File Canary CopylSite Notice