HomeMy WebLinkAbout2000-P02472 - sewer connect � -�
PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po2a�2
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(612) 249-4600 Date Issued: siisioo
SITE ADDRESS: 160 Smith Ave
WAYZATA,MN 55391
P I D: 02-117-23-21-0029
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
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TOTAL FEE: $35�
APPLICANT: �DMER nvc OWNER: M N&M K NICOLL
BOX 219 160 SMITH AVE
ST.BONI,MN 55375 WAYZATA MN 55391
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII,DING CODE REQUIREMENTS.
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ISSUED BY SIGNAT
Copies: City,Applicant,Assessor,Finance Page 1
'� � CITY OF ORONO APPLICATION FOR UTILITY PERNIITS
Boz 66 (2750 Kelley Parkway) SEWER/WATER
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. Permit cards will be sent by
retum mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6: Contact the Public Works Departrnent (249-4600)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
Departrnent. 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. Ca11249-4600.
24 hour notice required.
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JOB SITE ADDRESS: //�,�
Occupancy Type: esidenti 1 Commercial
Owner's Name: Phone l�mber:
Mailing Address: / /�{_ City: �1 7�p:
Contractor's Name: ` Phone Number: �S/l� -��95T
Mailing Address: City• 7ap:���>"
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size_�inches; material �chedule 40 air tested; cast iron
SAC Charge ($1,050.00) must accompany all sewer pernut 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 �
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters= $130.00; 3/4" meters= $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(249-4600) 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
included for each well,sewer and water connection permit requested.
3. Postage &Handling(Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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 complete, true and correct.
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Signature of Applicant: �i.�'� Date: S �� ���