HomeMy WebLinkAbout2007 - P11302 - sewer/water disconnect PERMIT
CITY OF ORONO
t 2750 Kelley Parkway- PO Box 66 Permit Number: P11302
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
8/6/2007
SITE ADDRESS: 2655 West Lafayette Rd Unit#
Excelsior,MN 55331
PID: 21-117-23-24-0039
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Disconnectic
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Burns Excavating,Inc. OWNER: Ronald&Esther Martens
3470 Co. Rd 21 2655 West Lafayette Rd
Mayer,MN 55360 Excelsior,MN 55331
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.
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APPLICANT PERMITEE SIGNATURE S• ED BY SIGNATURE •
Copies: I-File(Signatures Required), 1-Applicant, I-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
4.
FOR CITY USE ONLY
� City of Orono Date Received: Permit#
HW V 1 P.O.Box 66
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2750 Kelley Parkway ❑In-House SAC Determination Form Completed
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
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 8 Re-Connection 0 Repairs ❑� Disconnect
Job Site/Owner Information
Site Address: 2655 West Lafayette Rd, Excelsior, MN 55331
Ronald and Esther Martens 2655 West Lafayette Rd,
Owner: Mailing Address:
City: Excelsior Zip: 55331
Home Phone: Alternate Phone:
Contractor Information:
Burns Excavating Steve Burns
Contractor: Contact Person:
Address: 3470 County Rd 21 1888
State License #:
Mayer55360 4/6/2010
City: Zip: Expiration Date:
(952) 955-3112 (612) 685-4303
Phone: Alternate Phone:
6
DETEMNING PERMIT FEES
0 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)
35.00
of Sewer Connection/ isconnect Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; 0 cast iron
El Water Connection Disconnect Repair($35.00/Per Stub) $ 35.00
Pipe size inc es;material Schd 40 air tested; I I copper
1. SUBTOTAL of Permit Requested: $ 70.00
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 70.50
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 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,true and correct.
Applicant: - a...�.,..a..,. Date: 08/06/07
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CITY OF ORONO CALLED IN v CZ,
INSPECTION NOTICE SCHEDULED 8-7-0,7 /
PERMIT NO. P//304Z__, COMPLETED
ADDRESS 2655 LV,
OWNER CONTR. I340,-^-4 ex-C--
TELEPHONE NO. 2' 40.8' 5 4L303
DESCRIPTION t5 P�Ld Ze-) C-- k-DtSC-87144.e c24-
LLQ 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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1:7 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
ti BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forth, next inspection 24 hours in advance. (952) 249-4600
Owner/ConTn site:
Inspector.
White Copy/Inspecto File Canary Copy/Site Notice