HomeMy WebLinkAbout2005-P09491 - sewer repair PERMIT
CI'T'Y OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 P09491
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
12/16/2005
SITE ADDRESS: 3645 Togo Rd Unit#
Wayzata,MN 55391
PID: 17-117-23-31-0034
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Michael Waage Contracting OWNER: Anthony Reed
2275 132nd Lane NW 3645 Togo Rd
Coon Rapids,MN 55448 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 ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
APPLICIANT PERMITEE SIGNATURE 0 IMI)BY SIGNATURE
Copies: 1-File(Signatures Required), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
FOR CITY USE ONLY
¢,0 City of Orono Date Received: Permit#
P.O.Box 66
2750 Kelley Parkway ❑In-House SAC Determination Form Completed
�?� Crystal Bay,MN 55323
$o (952)249-4600 Approved By(If Required):
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CITY OF ORONO-SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
(ALL PERMITS- May be subject to further review and may not be issued when the application 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. Permit cards will
be sent by return mail within 2 business days.
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.
TYPE OF PERMIT
(Check All That Apply)
"' Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑Additional Connection ❑Re-Connection 15d Repairs ❑Disconnect
Job Site/Owner Information:
Site Address:
Owner: t=. - � ����� Mailing Address: 3
`TOG-t� 2�
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: A� e-L 1A-GZ- �Contact Person: U f Cg-0,z�
Address: ZZ7�_ (3z'"° ` " �St to License#: ( V a
City: iZip4-?�f4Expiration Date: �l
Phone: 7�� 2 -O�19 3 Alternate Phone: -76 3 -7� Co& 7
DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,450.00) $ r
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid, a sewer connection permit will not be issued)
2� U
F1Sewer Con ntion/Disconnect/R U
air($35.00/Per Stub) $ J
Pipe size 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
i
2 �
1. SUBTOTAL of Permit Requested: $ J� o
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 2 00
ADDITIONAL INFORMATION'-WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of meter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all work iM
h the ordinances of the City and the regulations of the State of
Minnesotaatements made on this application are,true and correct.
Applicant: Date. ��
/ D TIME V
CITY OF O O R NO CALLEDD IN `G�
INSPECTION NQTIC SCHEDULED '
PERMIT NO. COMPLETED
ADDRESS ��� CT I(DWQ
OWNER CONTR.. &
-7
TELEPHONE NO. !&3 -a86 -
DESCRIPTION
01 FOOTING 11 MECHANICAL RI U 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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WXRK SATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
ujW ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance. (952) 249-4600
OwnedContrac s :
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice