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Home My WebLink About2004-P07918 - sewer connect � ` PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway- PO Box 66 P07918 Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut (952) 249-4600 Date Issued: 9/7/2004 SITE ADDRESS: 130o Spruce Pl Mound,MN 55364 PID: 08-117-23-32-0016 DESCRIPTION: Proposed Use: Residential Permit Class: General Pernut Sub-type(s): Sewer Connection Permit Type: Sewer and Water Permit 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: Widmer Construcrion LLC OWNER' Killian's Gate LLC(Dr.Dennis Killian) 9455 County Rd. 15 � 1300 Spruce Pl Maple Plain,MN 55359 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 NIINNESOTA BUILDING CODE REQUIREMENTS. v � � PLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Couies: 1-File(Si�nitures Required), 1-Aunlicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1 � L (Updated 1/5/04) CITY OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC Crystal Bay, MN 55323 GENERAL INFORNIATION 1. You may apply for utility pernuts 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 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 pernut card is available on the job site. 5. Utility comiection pernuts 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 pernut does not grant this approval. 7. All work must be done in accordance with State Code requirements. 8. All work nnist be inspected before it is covered. Call(952)249-4600, 24 hour notice required. JOB SITE ADDRESS: ��D ��-c�'�� / Occupancy Type: l� Residential Commercial Owner's Name: ��i� �%�<<% � �� • Phone Number: Mailing Address: City: Zip: Contractor's Name: (,�/�/�c.. Gi,�sroKr.�-�L;G �Phone Number: �'! Sa �5-3— �D� 2 Mailiug Address:/`�",f-.s- c.� ��/,1""��ii�/�%=� City: Zip: S5 3S 5 � PERMIT TYPE [�Connections ❑Repairs ❑Disconnect (Check One) SAC Charge (2003 rate $1,350.00) $ (Set Rate) Sac Charge must accompany all sewer permit applications unless prepaid. (If not prepaid, a sewer connection will not be issued) Municipal Sewer Connection/Disconnect/Re�air ($35.00 per stub) $ pipe size y inches; material �Schd 40 air tested; cast iron Municipal Water Connection/Disconnect/Repair ($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 (Minimum) The State Building Code Division Surcharge of$.SO per pernut must be included for each well,sewer and water connection permit requested. 3. Posta�e &Handling (Only mail-in applications) $ 1.50 (Mail In Only) 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. �� i Signature of Applicant: �� - Date: �-�'�'� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. I�c'7q \�f COMPIETED °��7-o`�i ADDRESS�3Ud SD��cc Placc OWNER CONTR. "`'��`^�� TELEPHONE NO. � DESCRIPTION S�-�.,c� N�Ok VP lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL Z 04 WALL BD. ATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 EWER HOOK-UP O6 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 � OWNER/CONTRACTOR TO MEET YOU:L`YES_NO c�n COMMENTS: a — l�_� �s,- a� � �- o � St� �° p�� a � 0 � W � Q � 2 W � W � � d W� ❑WORKSATISFACTORY:PROCEED �AOJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. v'1`"�� White Copyllnspector's File Canary CopylSite Notice ✓ D TE ��,/ TIME CITY OF OR O CALLED IN � ��S! / INSPECTION NOT CE SCHEDULED �� 'p � PERMIT N0.� COMPLETED 1� -o� ►OT•aC) ADDRESS �3 �U C� �"/wG�. OWNER CONTR. GtJi%�K�2.�' TELEPHONE NO. CP`a Sd / �C��.S� � DESCRIPTION �C wc� C�^neC''�' � 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 - 17 SITE INSPECTION Q OS FINAL EWER DH�K-UP 06 PROGRESS � 07 DEMO-SITE 27 . 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU�YES_NO � y COMMENTS: _` D� z�5v� �. �Sfi pIL � � W w y,. a p� � � .p c ne�,— a�� --��,�. o �-� �` r�;s� �c �� bti s�<<Qa— . �. � 0 � W � Q � Z W � W � � � ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED �� ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice DATE TIME ✓ CITY OF ORONO CALLED IN INSPECTION NOTIC-7E�) SCHEDULED �'�`�'�`{ PERMIT NO..�D/7�� COMPLETED � ADDRESS I3O0 S Q t�t c �qC� OWNER CONTR. TELEPHONE NO. � DESCRIPTION Sew t< <O��«�,v.� � 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. 1 ATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 EWER HOOK-UP 06 PROGRESS � 07 DEMO-S�TE SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�l/ES_NO v�i COMMENT : W a P s �,�, D �o w, (�u �� 0 � oa - � D 0 � W � Q � z W � W � � O � ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑C RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONOITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Cail for the xt inspection 24 hours in advance. (g52) 249-46�� OwnedContr site: Inspector. -- White CopyllnspecloPs le Canary CopylSite Notice