HomeMy WebLinkAbout1991-003950 - sewer/water .� PERMIT
�' CITY OF ORONO PERMIT TYPE: :�:E:WER << W�;��
1335 Brown Rd. South • P.O. Box 66 Permit Number: t'��•'����j
Crystal Bay, Minnesota 55323 Date Issued: `'3'�� �'�" ��'�'
(612) 473-7357
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE >
CITY OF ORONO APPLICATION FOR DTILITY PERMITS
� Box 66 (1335 So Brown Rd) SEWER WATER O
' Crystal Bay, MN 55323 3�S
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I:--You mai yt Fply�or utility permits by mail or in person at the City offices.
2. Mailed in applications are subject �to �tY�e postage and handling fees shown below.
Permit cards will be sent by return mail the same day the application is received.
3. Pe=mits are nat valid imtil you reoeive a pe�it card.
4. Work must not begin unless the permit card is available on tY:e job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY SZREET 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. Ca 11 473-7357.
24 haur notiae requiY�ed.
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JOB SITE ADDRESS: 3 Y I(� S�v f���+��-j 1//��
Occupancy Type: �_Residential Commercial
OWNER'S NAME: `�y�-��' ��;;�� ��l �'�c��� � Phone No. :
Mailing Address: City:
CONTRACTOR'S NAME: X=C�v�'�1 � �='�� �-�-�`��� Bus. Phone: f�-�- � �
P: -, c/
Mailing Address: ���/ C'o � I J City: vYfe��, h Zi �'
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PERMIT TYPE AND FEB CALCIILATION
MIINICIPAL SEWER CONNECTION ( $30 . 00 per stub) $
pipe size � inches ; material �C PVC (on sand fill) ; cast iron
SAC Charge ($650.00 ) must accompany all sewer permit applications unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WAT$R CONNECTION ( $30 . 00 _per stub) $
pipe size �inches ; material �� copper; other
WATER METERS- must be picked up and paid for at City Ha .
(5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 )
Water meters must be set and sealed by Orono Water Department (473-7357)
upon completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
RE�UIRED setback from sewer line = 20 '
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l. Subtotal of above permit requested $
2. State Surcharge . 50
The State Building Code Division Surcharge of .50 per permit must e
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 a 11 work in strict accordance with the ordinances of the City and the
regulations of the State of Minnesota, and cer �f�s that all statements made on this
application are c�lete, true and correct.�
�-,
Signature of Applicant: � Date: 7-�� - �� �
I � DATE / TIME
CITY OF ORONO CALLED IN f ' - �a!/��'�
INSPECTION NOTICE � SCHEDULED - ' `
PERMIT NO. 6��I.`l � COMPLETED �l I W-
ADDRESS S �.
OWNE ��2��� CONTR. Lc��-a�a�+ �� .S. Gc�
TELEPHONE N0. � � a - ��s9
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLINCa
O031NSULATION 2M25'WO ER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WALL BD. 12 WATER HOOK•UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETIT N ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO �
y COMMENTS: � WO�A.L_ Cc7 U.e�_ c,c�,
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d WORKSATISFACTORIFPROCEED ❑ PROJECTCOMPLETE
W
� �CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFbRECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATiON ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Caii for the next inspection 24 twurs in advance.473-7357
OwnedContra on-�site:
Inspector. U
White Copynnspectors Flle Canary CopylSNs Notics