HomeMy WebLinkAbout1994 - 006394 - sewer hookup PERMIT
4 Crry OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: SEWR ,N WAlER
006. 4
Orono, Minnesota 55356-0815 Date Issued: 02 1 94
(612) 473-7357
SITE ADDRESS:
WESTLAKE ST
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P 0!- -1P-2S- -001S
DESCRIPTION:
SEWER HOOKUP
Sewer & Water Permit Type SEWER CONNECTION
Water Work 1ype RESIDENCE
CITY OF ORM
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - Anplicanr_. - OWNER:
c yv F-, H 4 7 3 Cle17 ANDERSON ED
1820
i W WAYZATA BLVD :7LS6 WESTLAKE ST
LONG LAKE1 N r .17,6
(612) 473-879:3
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL C OF
ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIRPMENTS .
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dr" APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE __J./7 e--4,
pi . .CITY OF ORONO APPLICATION FOR UTILITY PERMITS Cn.%s'
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 noticerr � required.
JOB SITE ADDRESS: 35L �1 _ Lq Sty ,+
Occupancy Type: X 4 Residential Commercial
Owner's Name: is A n dee S Q yl Phone Number:
Mailing Address: 3ct, t,J. Cil .5+-.1 i City: Bp:
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PhoneNumber: Li 7317
Contractor's Name: �,}� U,�(?� P {�-f T� 9 3
Mailing Address: RD , c)x ) S'0 City: (_pmn Lotto Tip: 3 %
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
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.
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Signature of Applicant: --� �V : CNC/ 9
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED < `ca
ADDRESS 3SG L)eJ-- L\e
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
4, 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 EWER HOOK-UP 06 PROGRESS
• 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
LIJ 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
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W C7WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
C ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r, 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
Owner/Contractor s e
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice