HomeMy WebLinkAbout1999-011662 - sewer connect *_ PERMIT
-ty OF ORONO PERMIT TYPE: _
2750 Kelley Parkway- P.O. Box 66 Permit Number: =' ` '` '� WA I ``'
Crystal Bay, Minnesota 55323
(612) 47"2-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — rel=P 1 i C•R V1 r• — OWNER: _ _ _ _ (�
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THE t NDERSIGNED HEREBY REQUE`:T, M'F'R ISSION TO MAKE TIS 'EAS ,,MFR VF.t E lT'S.
SPECIFIED AND 'AGREES, •1.O 00 ALL ��R I Int STRICT COMPLIANCE ,W ITTN AI.L CITY t
L t��,�"N t ORDINANCES AND STATE t�F M I E�:��T�i �.t J l i~D I l�� C�+GE
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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 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 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 (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 249-4600.
/`w- 24 hour notice required.
JOB SITE ADDRESS:
Occupancy Type: 4Residential Commercial
Owner's Name: Phone Number: 473
Mailing Address: e-Z City:
Contractor's Name: Phone Numb
Mailing Address: L City:_ZLy, S.Q Zap:
PERMIT TYPE
Municipal Sewer Co nection ($35.00 per stub) $
pipe size inches; material L---S-chedule 40 air tested; cast iron
SAC Charge ($1,0 0.(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 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 meter 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 Surcharge $ .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.
Signature of Applicant- G �✓ Date:
E
0 MUCA Pipelayer Training Certification
1 Douglas A. Ouverson
has completed the Pipe Laying Training
Course through the
or
Minneei6a i ity Con A5eociation
1
and is a Certified Pipe Layer having completed
the required course work in pipe laying and the
Minnesota Plumbing Code
This card ce
rtrfies that the cardholder
has completed training in the required areas
of the Minnesota Plumbing Code related
to PiPe Laying as determined by the {
Minnesota Department of Health
i
Cud Number.
0650 LVO
J0 Minnesota Utility contractors Association
6043 Hudson Road,Suite 378,Woodbury,MN 55125
J_ — (651)735-3908,1-800-567-MUCA (651)7354018(fax)
S
DATE TIME
CITY OF ORONO CALLED IN -7 3 Od
INSPECTION NOTICE SOHEDULED �7 a(o 31-06
PERMIT NO. !I(�lv`� COMPLETED
ADDRESS 4'10 Ryl J4IiWCZ__ ,J .
OWNER ,,11 QQ pCONTR.
`77r ��dAyU'L
TELEPHONE NO. - ,r 917
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
CO03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWERHUUK118 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
I 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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ORK SATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
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 inspectio 124 h n advance.4 3-7357
Owner/Contrac r o site:
Inspector.
White Copy/Inspe s File Ca ry Copy/Site Notice