HomeMy WebLinkAbout2008-P11867 - sewer/water connect unit 100-150 • PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P11867
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
2/12/2008
SITE ADDRESS: 2060 Wayzata Blvd W Unit#
Long Lake,MN 55356
PID: 34-118-23-21-0035
DESCRIPTION:
Proposed Use: Commercial-Business
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:
Unit#100–-SAC Paid#P11641 - 12/14/07
FEE SUMMARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Owner/Self OWNER: Interspace West
MN 2060 Wayzata Blvd W
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO/ LL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUIL P ' G CODE REQUIRE r ENTS.
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An. LICANT P."4 ITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
City of Orono Date Received: Permit#
/0 " O P.O.Box 66
2750 Kelley Parkway 0 In-House SAC Determination Form Completed
P`* ; t Crystal Bay,MN 55323
\+IyE (952)249-4600 Approved By(If Required):
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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
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)
04 New Connection ❑Additional Connection in Re-Connection ®Repairs ® Disconnect CC-)
Job Site/Owner Information: /'(
Site Address: c-) 6 0 k), W /Aid l,�'(` IT `�`'
Owner: g,4 bey-- W hoc LL-- Mailing Address: p & s 70
City: b./0.11/--e Zip: �_5 3F /
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Home Phone: (L CbG Alternate Phone: G �
Contractor Information:
Contractor: c�� pr � ��� Contact Person: 0A
Address: PO 8 i 62) State License#:
------City: Zip:--T3?
Expiration Date:
Phone: l Z 1202- qJ Os-- Alternate Phone: Li't
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4$09t;
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 Connect,ipn� /Disconnect/Repair($35.00/Per Stub) $
Pipe size (4± inches;material Schd 40 air tested; cast iron
Water Conn ctio /Disconnect/Repair($35.00/Per Stub) $
Pipe size Oki'1nches;material Schd 40 air tested; I 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) $
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 in strict accordan - with the ordinances of the City and the regulations of the State of
Minnesota, and ertifie- t .t all statemen s made on this application are,true and correct.
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Applicant: .///1 Date: `/g` Or
Rese iFor
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C / W; //I ATE �i TIME \./
CITY OF ORONO 19j`O (0 7 CALLED IN a` ' .or
INSPECTION TI i SCHEDULED c2// /c2 /.3C
PERMIT NO.fid 2 9 COMPLETED
ADDRESS oZ t)62 0 (2.)
OWNER (A" ' rkz` CC° ONTR.
TELEPHONE NO. 4', —Lif--- 5/0
DESCRIPTION ~ /
L4 ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
V/ ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
• ❑ WALL BD. WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT
v 0 DEMO-FINAL 0 SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI 0 SEPTIC FINAL 0 HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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WORK SATISFACTORY:PROCEED X ❑ PROJECT COMPLETE
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
O• BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
LI 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 sit _ _
Inspector. -
White Copy/Inspector's File Canary Copy/Site Notice