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Home My WebLink About2007-P11770 - sewer disconnect PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P11770 Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit (952) 249-4600 Date Issued: 12/21/2007 SITE ADDRESS: 1220 Tonkawa Rd Unit# Long Lake,MN 55356 PID: 08-117-23-42-0001 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Disconnect DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Sewer Disconnect FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: Thompson Plumbing OWNER: Micheal Ebertz 15001 Minnetonka Ind.Rd. 1220 Tonkawa Rd Minnetonka,MN 55345 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 MI TA BUILDIN:CODE REQUIREMENTS. i Cj&' APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 A. FO IT USE ONLY 177 �¢0 �\ City of Orono Date Received:* QD Permit# P.O.Box 6G 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �h>l, Crystal Bay,MN 55323 (952)249-4600 Approved By(If Required): 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 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 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. TYPEOF PERMIT' Check All That Apply) ®Residential(May Require Approval) ® Commercial(Approval Required) ®New Connection ® Additional Connection ® Re-Connection Repairs XDisconnect Job Site/Owner Information: Site Address: Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: p Contractor: YW � 1 �6� Contact Person: IG6, S P— I�b n Address:�.7Q0/ H f qState License #: 95,P2 eZ' City: Zip:Expiration Date: �Z 3/ 2A94 Phone: q5; Alternate Phone: 0, DETERMINING PERMIT FEES SAC Charge(2007 Rate=$1,675.00) $ (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) Sewer Connec '�nisc�onnectepair($35.00/Per Stub) $R c'o Pipe size Schd 40 air tested; 0 cast iron Water Connection/Disconnect/Repair($35.00/Per Stub $ Pipe size inches;material Schd 40 air tested; copper 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50' 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 155,�J50O 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 i stri t accordance with the ordinances of the City and the regulations of the State of MinnesotYa certifies th all statements made on this application are,true and correct. Applicant: Date. Reset Form C�"� Ste+- , 7 TIME / CITY OF ORONO CALLED IN D{� 7 l V INSPECTION_PTSCHEDULED t-? PERMIT NO. �-70 COMPLET ED ADDRESS Ed OWNER CONTR. TELEPHONE N0. 5 33 - 77/ DESCRIPTION ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAWGRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBING FINAL x' ElFOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOB:`► YES_NO cam., COMMENTS: W a o � 1 Sew � D. S - [� ►� cc 0 U_ W cc Q 2 W Z W 0 Wj {WORK SATISFACTORY.PROCEED ElPROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ 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 Owner/Contractor on 'te: Inspector. White CopylInspector's File Canary Copy/Site Notice