HomeMy WebLinkAbout1992-004731 - sewer connect P�,R,MIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 �:����� Yt ��TE:�;
Permit Number: t rt x�?:;�
Crystal Bay, Minnesota 55323 Date Issued: j��!�i��'a�=
(612) 473-7357
SITE ADDRESS:
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APPLICANT/PERMI EE SIGNAT ISSUED BY:SIGNATURE����
CITY OF ORONO � APPLICATION FOR UTILITY PERMITS
Box 66 (1335 So Brown Rd) - � SEWER WATER
Crystal Bay, MN 55323 T i� ��/�
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I:-You mai y apply�tor 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.
3. P�its are nat vali�d until yo�i reoeive a ��*�+;t c�rd.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection pPxmits may be issued to licensed oontractors only.
6. Contact the Public Works Department (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IlJ ANY STREE,T AI�ID DO N(yr TAP ANY MAIN without express approval of the
Public Works Departznent. Issuance of a pezmit 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 haur mtioe r�quired.
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JOB SITE ADDRESS: �/S S s�d��G/�U� �� -
Occupancy Type: Residential �G Commercial
OWNER'S NAML: ,S�J/T/-< ��� �yf�//�� Phone No. :
Mailing Address: City:
CONTRACTOR'S N�: o� �i? '�G�3�'� �� • sus. Phone: y�9�/9'��
Mailing Address: ���� �� /P ��G City:�'1,¢P�F�liAj,-i> Zip: �
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_ - P$RMIT TYPE AND FEE CALCQLATION
MIINICIPAL SEWER CONNECTION ($30. 00 per stub) $ 3�� �
pipe size _�inches; material �PVC (on sand fill) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WATER CONNECTION ($30.00 per stub) $
pipe size inches; material copper; other
WATER 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)
Water meters must be set and sealed by Orono Water Department (473-7357)
upon campletion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20 '
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1. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must be
included for each well, sewer and water connection permit requested.
3. Postage � Handling (Only mail-in applications) $ 1. 50
4. TOTAL PERIKIT FEE (add lines 1-3 above) $
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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 co�lete, true and correct.
Signature of Applicant: L%l/ � Date: /� �� �4a
✓
�� ,D�A�TE� TIME
CITY OF ORONO CALLED IN 1���
INSPECTION NOTICE SCHEDULED /�� �
P�RMIT NO. 7 COMPLETED u ��
ADDRESS � `
OWNER�-�l L�'/-// /!��ONTR.7..l,T��
TELEPHONE NO. "7 7 1 — l � ��-
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 T URN ON 17 SITE INSPECTION
� 07 DEMO—SITE EWER HOOK-UP� 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W q�WORKSATISFACTORY:PROCEED GPROJECTCOMPLETE
� �O CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r. pHOTOTAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALLINSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr tor site:
Inspector. •
White Copyllnspector's File Canary CopylSite Notice