HomeMy WebLinkAbout2001-P04102 - sewer connect f E
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po4io2
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600
Date Issued: �i19i2ooi
SITE ADDRESS: 1270 Spruce Pl
Mound,MN 55364
P I D: 08-117-23-32-0013
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:
NOTlCES/REMARKS:
FEE SUMMARY: PermitFee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: W�dmer Inc. OWNER: Mr.& Mrs. Erickson
Box 219 1270 Spruce Pl
St. Boni, MN 55375 Mound MN 55364
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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PLICANT PGRMITEE I NATURE ISSUED BY SIGNATURE
Copies: 1-File(Signitures Reguired), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1
+ �t (Urvated Z/12/O1)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 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 fee shown below. Permit cards will be sent by
return 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 Department (952-249-4600) 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 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.
JOB SITE ADDRESS: ��7c% -5����-� ��-�� �
Occupancy Type: �f'/�2esidential Commercial
Owner's Name: �� /�;i�.sc.� Phone Number:
Mailing Address: City: 7ip:
Contractor'sName: wd�/,���- .,,�'��= Phone Number: y.s'� -yy��%�fs-
Mailing Address: �n r��,� ��i City:'�j/;,-,�=�:L� 7�p: 5�=3�..5��
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) ;.;-�-'""� � $
pipe size�inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00) must accomp�an ai�sewer permit 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.
Water meters must be set and sealed by Orono Water Department (952-249-4600) upon
completion of ineter installation.
REQUIRED minimum setbacks from drain field 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 & Handlin� (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 Pertnit, 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�/��, � ���--���� Date: %--��r'i,�
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