HomeMy WebLinkAbout2008-P11985 - sewer/water connect CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P11985
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued:
4/18/2008
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&Water Connections
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: 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
MINNESOTA BUILDING CODE REQUIREMENTS.
APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
FOR CITY USE ONLY
D�O�C City of Orono Date Received: Permit#
P.O.Box 66
2750 Kelley Parkway 0 In-House SAC Determination Form Completed
3Crystal 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 aonli •Finn is received)
GENERAL WORMATION
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 ®Repairs ❑Disconnect
Job Site/Owner Information:
Site Address:
Owner: ailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
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Contractor: JContact Person: w (J
Address: ! "tate License#: 91�asxzr ern
City: Zip:� WExpiration Date: 12
Phone: 9� -933--77/7 Alternate Phone:
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13SAC 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)
13Sewer Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material 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: $ �✓�,06
2. STATE SURCHARGE $ 50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ -
ADDITIONAL INFORMATION-WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a swarate 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 in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota,and c ifies that all statements made on this application are,true and correct.
Applicant: Date:
C5J1 - AT TIME
CITY OF ORONO CALLED IN
INSPECTION NO SCHEDULED _
PERMIT NO. COMPLETED
ADDRESS la e9
OWNER CONTR.
TELEPHONE NO. 95Z 7717
DESCRIPTION
tj El FOOTING E] MECHANICAL RI E:1EXCAV/GRADING/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
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
OWN ERICONTRACTOR TO MEET YOU:_YES_NO
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WQCXwORK SATISFACTORY:PROCEED ElPROJECTCOMPLETE
WORRECT WORK R PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
11 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 site:
Inspector. ( ') (,,r-(, 6243S
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White Copy/Inspector's File Canary Copy/Site Notice