HomeMy WebLinkAbout1994-006410 - water meter �,. PERIVIIT
� ' CITY OF ORONO PERMIT TYPE:
2750 Keliey Parkway • P.O. Box 815 Permit Number: ��={���'�'���'
Orono, Minnesota 55356-0815 +_'�t�=.�'�"
(612j 473-7357 Date Issued: {���,;r-;;�;,i���.
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APPLICANT ERMITEE SIGNATURE � ISSUED BY:SIGNATURE �,
� CITY OF ORONO APPLICATION FOR UTILITY PERMITS =I��'-���
` Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for utiliry 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 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 connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department (473-7357)forutility 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 473-7357.
24 hour notice required.
JOB SITE ADDRESS: 2�� �v�-�-��'`'�� S
Occupancy Type: �_ Residential Commercial
Owner's Name• �oT�-��-�=--�� ���o�-�-N^-�--' PhoneNumber:
Mailing Address: City: d�Li�� 71p:
Contractor's Name: ' � �-l-�a�P�a�J ��, C� r' �one Number: ��"3"�t�---�����'
Mailing Address: 1��� tit`(�v'k�c�-'�� �-+� City: M"Il��- 71p: S53`15
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) / �
pipe size � inches; material ✓ PVC (on sand fill); cast iron
SAC Charge ($800.00) must accompany all 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 �opper; other
WATER METERS must be picked up and paid for at City Hal .
(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meter = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Depa ment (473-735'n upon
completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERI�ZIT 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 pernut 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 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.
Signature of Applicant:
�� ��C___�,�_..e_ Date: ! � �
DATE TIME
CITY OF ORONO CAL�ED IN `��..Z� /%s`
INSPECTION NOTICE SCHEDULED `/.=Z�/Sy` ��-'
PERMIT N0. / � COMPLETED �.__ �
ADDRESS C�O :->z--��-'
, ��
OWNER , � � CONTR. L✓/ ��'�1���✓
TELEPHONE N0. ��� � ����
� DESCRIPTION f � ��C2D� , �.�J -c.� �.�
� 01 FOOTINd 11 MECHANICAL RI 6�`'18 CAV/GRADINd/FILL d
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UO 06 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
_ �9 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� BING FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED _- ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR - CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
OwnerfCo r on 'te
Inspector. . �
White Copyllnspector's File Canary Copy/Site Notice