HomeMy WebLinkAbout1993 - 005540 - sewer connect PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number SEWER & WATER
Orono, Minnesota 55356-0815 00.5.1;40
Date Issued:
(612) 473-7357 03/27/93
SITE ADDRESS:
332 Ti AKE Si
LSV
P . I . N. : 0S-117-23-23-0012
DESCRIPTION:
SEWER CONNECTION
SPwPr & Water Permit Type SEWER CONNECTION
Sewer & Water Work Type RPSIDENCP
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•
REMARKS:
FEE SUMMARY:
Base Fee $35 . 00
Surcharge 1.isc)
Total Fee
CONTRACTOR: - APPlicant - OWNER:
CITYVIEW
LLEG & HTG BIC.:HnN I C:H RI
1880 1/2 W WAYZATA Bun :332 WEST! (4::E ST
ONG LAKE OR Ci N MN L . i ._
473-S793
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
L_ ORONO ORDINWCES AND STATE OF MINNPSOTA RUILDING CODE REWIRPMENTS .
4e,
APPL A T/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323 S/ 6
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.
JOB SLUE ADDRESS: 33 a wej r t cf ko, 5-1-cezt
Occupancy Type: Residential Commercial
Owner's Name: 1 r 11 r,v1 i 6 PhoneNumber:
Mailing Address: 33 4,le5+ (Ve, .ee City: a o✓; c) 7p:5S3.5�
Contractor's Name: (,1-}- O;P,\,J V u y^^,,,✓'Ion Phone Number: LJ-)3-�-7 9 3
Mailing Address: Q,o , �j0 x /5-0 J City: LOII Lq jp Zip: SS' 6-4.,
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size 9 inches; material S11y() PVC (on sand fill); cast iron
SAC Charge ($750.00) 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.
4-1,L)
Signature of Applicant: i -�---
Date: ,/7 IP
Al- DAT TIME
CITY OF ORONO CALLED IN o2/ / iL.: 1..) -
INSPECTION NOTICE .,16 SCHEDULED '-- O -0 /.e-b J
PERMIT NO. � COMPLETED _�� �
ADDRESS 23 �- '
OWNER!` 4 z� CONTR. ...0.------
TELEPHONE
.0 -TELEPHONE NO. 1/73' 4' & / ,
DESCRIPTION
4, 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
0
• 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 RN ON 17 SITE INSPECTION
07 DEMO—SITE 14 SEWER HOOK-UP...." 06 PROGRESS
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`4 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. P PHOTO TAKEN
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.473-7357
OwnerIContrac o ite:
Inspector. -V
White Copy/Inspector File Canary Copy/Site Notice