HomeMy WebLinkAboutP006422 - sewer hookup PERMIT
CITY OF ORONO PERMIT TYPE: sf.-WER wAl R
2750 Kelley Parkway • P.O. Box 815
Permit Number: 001;422
Orono, Minnesota 55356-0815 Date Issued: 09/12/94
(612) 473-7357
SITE ADDRESS:
575 OXELJ::N
L.:5V
PIN : 05-117-234 -0025
DESCRIPTION:
SEWER HOOKUP
Sewer & Water Permit Type SEWER CONNECTION
Sewer & Water Work Type RESIDENCE
13133'00000
;31 35.00
1 222 aU)00
r r .50
REMARKS:
FEE SUMMARY:
Base Fee $:35 . 00
Surcharge
Total Fee $35 . b0
- icant -
C90,TPAVAR:9ERV1C:E .; IN : '
la7: 1.5300 OWNER: JAMES
3660 HWY 101 S 575 OXFORD RO
WAYZATA MN 5b3q1 OWVO MN
Al2) 473-4.300
THE UNDERSI6iNED HEREBY REQUESTS PERMISSION 10 MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH AIL CITY OF
ORONO if AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS .
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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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(473-7357)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 473-7357.
24 hour notice required.
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JOB SITE ADDRESS: . 7� 64,1_,AJOA2,i2
Occupancy Type: Res'de ti Commercial
Owner's Name: itdi�/i 1. 1 PhoneNumber: L/73--7_.Z
MailingAddres c*-' A__-A__1 L,.- O City: L Jo. Tap: 4-4- 5
' i ,, Phone Number: ?_7 —Li 3 cry
Contractor's Name: , � _
Mailing Address: ‘,.1.,, _ . a City: &c.v.:7, " 71p: h"2f /
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stu ) $
pipe size inches; material PVC (on sand fill); cast iron
SAC Charge ($800.00) 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 = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters 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 = 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: Date:q/
) '2- ) i--/
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DATE TIME
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CITY OF ORONO CALLED IN ! ,26 5'q
INSPECTION NOTICE / SCHEDULED I - a,4 /= 0-0PERMIT NO. co s' COMPLETED/� K I
ADDRESS -5-25 Ol d 4,
OWNER /414-1 / CONTR. .h &-
TELEPHONE NO. 4"7 3 ` (/ 3 0 6
DESCRIPTION
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01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
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02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-017 SITE INSPECTION
Q T
= 05 FINAL 14 SEWER HOOK-UV 06 PROGRESS
I. 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
✓ 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
' OWNER/CONTRACTOR TO MEET YOU:_YES N?
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CC ❑CORRECT WORK&PROCEED C ISSUE CERT FICATE OFF�GG'VPAfbIL`Y
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O ❑ CORRECT WORK,CALL FOR REINSPECTION T MPORARY
OU BEFORE COVERING P:-MANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. P 0 TAKEN
INSPECTOR WILL RETURN
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❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner!Contractp site:
Inspector. avl
White Copylinspector's File Canary CopylSite Notice