HomeMy WebLinkAbout2007-P11038 - sewer connect � � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box t!� Permit Number: P11038
Crystal Bay, Minnesota 5�323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued:
5/23/2007
SITE ADDRESS: 1295 Sixth Ave N Unit#
Long Lake,MN 55356
PID: 26-118-23-34-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS: �����
Approved per resolution#: �\�7" -f S
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Separate permits required: � ���`� '� v
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NOTICES/REMARKS: C1V�
SAC Paid 5/22/07-Seperate Ck#8161 By Homeowner
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
SAC Fee: $ 1,675.00 ���c-� (�� .
I � l cr�r�Q c�v�-v�a-� C I� �� gl l0 1
TOTAL FEE: $ 1,710.50
APPLICANT: Thompson Plumbing OWNER: John&Madonna Rotondo
15001 Minnetonka Ind. Rd. 1295 Sixth Ave N
Minnetonka,MN 55345 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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City of Orarb
P.O. Box 66
(955c')249�4b00� 55323
05/23/07 09:04:42
Custa�r: P11038
PERMITS - 6ENERF�.
1@ 4.00 0.QO
Base Fee
Plan RevieM ��� ���
Mail in Fees �'� 0.�
1 8 0.00 0.0p
State 5urcharge
i@ 0.50 0.50
SAC Charge
1 @ 1675.00 1675.00
Investigation Fee
� 1 @�T O.OQ 0.00
1 @ 11810.00 11910.00
1295 SIXTH AVE N.
SfWER CO�L�ECTION FEE5 + �
T�TOTAL 13,520.50
TOTf� Si�.E ���
13 5�0.50
Check Received l�p.gp
�� 0.00
CLERK# 02 TRAN5# 30659
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P'OR CITY iiS1:ONLl'
,.¢��:,\ City Of O�'Ono Date Received: Pennit#
� P.O.IIos 66
��, Q�� 2750 Kelley Parkway ❑In-House SAC DeterminaCion Porm Completed
��y� ij�� � �� Crystal Bay,MN��323
� ;, r.o;,i (9�2)2a9-d600 Approved By(IfRcquircd):
�:!R'E�aiso�,`..:;,
CITY OF ORONO—S�WEl2 & WATER/ GENERAL P�RMI7,
(*Note:Some permits may require approval by thc I3uilding OfCicial and/or Public Works Dcpartmcnt*)
(;\LL PL,Ri�ll'I�S- ��iav be subject to further revicw�nd m�iv not be issued titi�lic��fhe:�ppiication is reccived)
GENCRAL INFORMA7'ION
1. You may apply for utility permits by mail or in person at the City offices.
?. Mailed iii applications are subject to the postage and handlin� fee shown below. Permit cards���ill
be sent by return mail�vithin 2 business days.
3. Permits are not valicl until you receive a per►nit c�rd.
4. Worl: must not be�in unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact tlle Public �Vorks Dcpartment(952-2�9-�4600)for utiliTy stub as-built locations.
DO NO"T F.SC.AVATE 1N ANl'STR�ET AND DO \OT TAP ANY NIt1IN without exp►�ess
�pprov�l of llie Public 1Vo►�I:s Department Issuance of a permit does not�I'1ttt t�11S 1�J�71'OV1I.
7. fUl wor(:must be done in accordance with State Code requirements.
3. All �vorl:must be inspected before it is covered. Call (952)?49-4600,14+hour notice requirecl.
TYPE OF PERMIT
(Check All That A 1 )
�'Residential (May Require Approval) � Commercial (Approval Required)
�i rew Coiinection � Additional Connection � Re-Connection �[]� Repairs � Disconnect
Job Site/ Owner Information: I
Site Addcess: /.,��J� ���:_��i ,���AO �
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O��mer: o /[�iv�]� lVlailiil� fAciclress: /� /,S �r��—,vTv
City: CS-,�� .,� n 7 ip: d-�n/� ,�,��
Home Phone: �5.�— ��� � 4f��� Altecnate Phone:
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Contractor Infocmation:
Contractor: ��Yrr,,Jsd.r� ��-uC����li.ontact Person: �,N�C� ,�,�oG��e4/
/�dclress: /5dc�_/ rL►/NN�T[�,�✓,�,4- >�v�:.�s�`/h�1te I�iceilse #:
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City: n'i��.v�vE7'o��:� 7ip:,�',��/ E�piration D1te:
P11one: �,� - `l,'�1 ��`J'7�7 Altecnate Phone: fS�-a�5— `3�`,�3'�
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' DETERMINING PERMI,T FEES _
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SAC Chaige(2007 Rate=�1,G75.00) �'�� $
(SAC Charge must accompany all se���er pern+�lt applications unless prepaid)
(Orono City Staff can dctermine if applicable)
(If ot prepaid,a se�ver connection permit will not be issued) �
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�cwer Connect' n/Disconnect/Repa' (�35.00/Per Stub) �
Yipe size�inches; material�Schd 40 air tested; 0_cast iron
� ❑� Water Connection/Disconnect/12epair($35.00/Per Stub) $
� / Pipc size inches; material _Schd 40 air tested; 0 copper
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� 1. SUBTOTAL of Permit Requested: $
�4' S
�/ ,1 1 � (1 2. STATL SURCHARGE $ .50__
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� ' ����3. POSTA-GE& HANDLING (Oniy on Ylail-In Applicatioi�s) � 1.50
�� �4. T�TAL PF[t�qOT F'��(Add Lines 1-; flbave) n
� ADD[TIONAL INFOI�MATION -WATER METERS
■ �'�'A"I'ER�IETERS must be picked up and paid for at Orono City Hall,these are on a seoarate permit.
m W,o"I'I;I� NiFTERS mast be sct and sealec� by Orouo Wate�• Dep�rtment (952) 249-4600, u�on
completion of ineter installation.
The undersigned hercby 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 tlle regufations of the State of
Minnesota, and certifies that all statements madc on this application are, true and correct.
Applicant: o„w� ` Date: 5'����
Reset Form
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DATE � TIME
' CITY OF ORONO CALLED IN ' �c7�—����,��/� -
INSPECTION NO E SCHEDULED JG��s��7 �-�
PERMIT NO. COMPLETED
ADDRESS � �C� .�`� �-3-t_. �"G� /�,%`�_ /U•
OWNER CONTR. 1��l l�Yt�L��
TELEPHONE NO. f � �� �� �3 �- 7 7l � �"�Lt/�b
j�'�. ��- �' ,
�- DESCRIPTION L�' �..�-��--'�-''�-'-�� �
� �� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/ LING
Q 02 FR,4MING 13 MECHANICAL FINAL 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 05 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 HARD COVER REMOVAL
J 10 PLUMBING FINAL / 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS: I L� �','c�-�(� ��C�'3`��c-�
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� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C, pHOTO TAKEN
INSPECTOR WILL RETUFN
❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
Owner/Contractor on site:
Inspector. �—�`
White Copyllnspector's File Canary CopylSite Notice