HomeMy WebLinkAbout2005-P08918 - sewer connect � � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p08918
Crystal Bay, Minnesota 55323 Permit Type:
Sewer and Water Permit
(952) 249-4600 Date Issued: 7/6/2005
SITE ADDRESS: 60 Smith Ave Unit#
Wayzata,MN 55391
PID: 02-117-23-21-0003
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: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Westonka Sewer&Water OWNER: Theodore Bonnett
6501 Co.Rd 15 60 Smith Ave
Mound,MN 55364 Wayzata,MN 55391
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 ORDWANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICAN ITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
,�0� Clty Of OrOriO Date Received: Permit#
� � P•O.Box 66
�ry � 27�0 Kelley Parkway ❑In-House SAC Determination Form Completed
��" �T{ ��µ.o`� (9�2)2 9a46 ON 55323 Approved By(If Required):
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CITY OF ORONO—SEWER & WATER/GENERAL PERMIT
(*\'ote:Some permits may require approval by the Building Ofticial and/or Public Worhs Department*)
(ALL PERMITS- N[av be subiect to further review and mav not be issued when the anolication is received)
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 fee shown below. Pernut cards will
be sent by return mail within 2 business days.
3. Permits are not valid until you receive a pernut card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locatious.
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(952)249-4600, 24+hour notice required.
TYPE OF PERMIT
(Check All That A ly)
�(Residential(May Require Approval) ❑ Commercial(Approval Required)
�].New Connection ❑Additional Coimection ❑ Re-Connection ❑ Repairs ❑ Disconnect
Job Site/Owner Information:
Site Address: ��U �v��� ��� /]��� �
Owner: �� , c_l , I�����f�' � � Mailing Address:
City: Zip:
Home Phone: Alten�ate Phone:
Contractor Information:
Contractor: �_�=5��" rl�' S � Contact Person: S�i�.✓� � lc� �
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Address: �;`��� ��' � F � � State License #: 1 C��>c��`�Z�'
City: (��'l���ti c� Zip:��� �Expiration Date: ��� - .��'c��
Phone: ���T'��`�) 7..�" yg L'C- Alternate Phone: ��l:? � 7�l�r 7?J
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DETERMINING PERIVIIT FEES :
❑ SAC Charge(2005 Rate=$1,450.00) $
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can deternune if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�,Sewer Connec �on/Disconnect/Re air($35.00/Per Stub) $
Pipe size L� inches; material�Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
ADDITIONAL INFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pemut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
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 state ents made on this application are, t-rue and correct.
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CIN OF ORONO CALLED IN
INSPECTION NO I�� SCHEDULED -� � '-Glo/�'t'1
PERMIT NO. �-1 � COMPLETED �e I �
ADDRESS_—C�� r-Sr���� ,��
OWNER CONTR. L'LJ.�S�II�►C�-
TELEPHONENO. __ C� �� � �� �7� � �/�i�i
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 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 OS FINAL � 4 SEWER HOOK- 06 PROGRESS
� 07 DEMO-SITE 2-7� MAINT. 21 COMPLAWT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FO�LOW-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:
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W� '�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR � CITATION ISSUED
C INSPECTION REQUiRED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector. G� .1 ,���
White Copy/lnspector's File Canary Copy/Site Notice