HomeMy WebLinkAbout2004-P07307 - sewer connect CITY OF ,OPERMIT
RONO Permit Number: �
2750 Kelleir Parkway- PO Box 66 P07307
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
952 249-4600 Date Issued: 3/17/2004
SITE ADDRESS: 680 Tonkawa Rd
Long Lake,MN 55356
PID: 05-117-23-33-0010
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:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE:
$ 35.50 i
APPLICANT: Plymouth Plumbing&Heating OWNER: Melinda Lee
12270 43rd Street NE 680 Tonkawa Rd
St.Micheal,MN 55376 Long Lake MN 55356
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.
APPLI ANT PERMITSESIUNATURE ISSUfD BY SIGNATURE
Conies: 1-File(Siznitures Required). 1-Applicant. 1-Monthly Reports. 1-Assessing, 1-Finance page I
%_i t Y mr umt)Nu APPLICATION FOR IJTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWERIWATER
Crystal Bay, MN 55323
I. 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 foes shown below. Permit cards will be sent by
return mail the sante day the application is received.
3. Permits are not valid until you receive it 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(473-7337)fa"utility stub aF-built locations. DU NOT.EXCAVATE.
IN ANY STREEFT AND DU NOT TAP ANY MAIN without express approval of the Public Works
Department. Issuance of a permit does not grant this approval.
7. Atl work must be done in accordance with State Code requirements.
8. All work trust be.inspected before it is covered. Call 473-7357.
24 hour notice required.
J0BSI1'F:ADDRESS: SSS 'T \-�, -.
Occupancy Type: X Residential Commercial
Owner's Name:_ i , f i�vr-zS' Phone Number:
Mailing Address: City: Zip:
Contractor's Name: 1-1 Phone Number, 7&3 riC/(F, % �Y
Mailing Address: o City: L �Zkr5 3"
URNIT TYPL
Municipal Sewer Connection 135.00 per stub) 0 $
pipe size A__ inches; matena)S(.t\4 PVC (on sand fill); bast iron
SAC Charge($900,00)must accompany till 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 _
WA"1"ER MITERS must be picked up and paid for at City]"Tall.
(518" meters - $139.00; 3/4" meters-$191.00; 1" meters=$247.00)
Separate Plumbing Permit issued for water meter.
Water tneters must be set And sealed by Orono Water Department(473-7357)upon completion
of meter installation.
REQUIRED minimum setbacks from drainfield and septic tanks=75'
REQUIRED setback from sewer line n 20'
PERMIT FEL G.,_ALCULATION
1, Subtotal of above permit requested $
2, Sttste.Such roe $i _50
The State$ul1d4 Code Division Surcharge of S.SO per permit must be
included for each well,sewer and water connection permit requested.
3. los aYg&Hudling(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
E41 work in strict accordance with the ordinances of the City and the regulations of the State of
N innesota, and certifies that all statements made on this application are complete, true and correct.
Signature of Applicant:_