HomeMy WebLinkAbout1995 - 006790 - sewer connect PERMIT
ITV OF ORONO
PERMIT TYPE:
2750 K iey Parkway- P.O. Box 66 Permit Number:
Crystalty, Minnesota 55323
Date Issued:
(612) 477357
SITE ADDRESS:
DESCRIPTION:
' •
REMARKS:
FEE SUMMARY:
CONTRACTOR: - OWNER:
ikF M(XE: THF HIL INPPIT.NEMFNT..':;
SHELI 1W0!7P,K* IN COMF''...IAWT:1-7. WITH ALL CITY 0:
OF MINT.JETA
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
ITY RONO APPLICATION FOR UTILITY PERMITS 6-'.7 U
C
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.
JOB SITE ADDRESS: I nap UOLQ Yl,i 1 1'v' t ��n.�t-Q..,.
Occupancy Type: X Residential Commercial
Owner's Name-01,} WIDAAE-. 4_ kSyCX1- PhoneNumber:
Mailing Address: City: Zip:
Contractor's Name:\\c\v f-1 \b\ (", PhoneNumber: q 3- ti''i 1'� 2,
Mailing Address:l 5 `(`rl`�rMc�ka City: `(JLC tip: -"Sc- 34S'
PERMIT TYPE
Municipal Sewer onnection ($35.00 per stub) $ ?)J.
pipe size —I 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 'onnection ($35.00 per stub) $ -?
,__:'o e- inches; material copper; other
a�`--�`ATER ' 'I !S 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 $ _- �� , '' j
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) $ ? -
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.
----� .Er Z Date: c - 3 R 5_'
Signature of Applicant:71 l,rl,�
DATE TIME
CITY OF ORONO CALLED IN -r CC
INSPECTION NOTICE SCHEDULED ' -C — 02- d
PERMIT NO. ( ' '7 /i COMPLETED << l(
ADDRESS / 6
OWNER �xR- i CONTR�- �a Y �� �
7 --
TELEPHONE NO. -' �� -7 '7 7
DESCRIPTION
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Le) 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOKUP 17 SITE INSPECTION
Q -
= 05 FINAL 06 PROGRESS
I` 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
tQ 07 DEMO-FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
C
4t1 Pi/Ci
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0
CC
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W
CC
2 )(WORK SATISFACTORY:PROCEED 4ROJECT COMPLETE
❑CORRECT WORK&PROCEED U ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerIContrac n si ciAA4
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
CITY OF ORONO CALLED IN 02 -gE 4r— to
INSPECTIONOTICE SCHEDULED o ' -5S 3.. o
PERMIT NO. 106 71 0 COMPLETED Pt-
ADDRESS !D 06 Ge..kbhte..M r- A /c
OWNER Ar L 9-A-Dc— CONTR. 114ierKiP3c>iV 14-Ont—g/�l.tc
TELEPHONE NO. 9 3 3 —7 7 f 7
DESCRIPTION
4.1
01 FOOTING 11 MECHANICAL RI 18EXCAV/GRADING/FIWNG
ct 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORENVETLANDS
Q 03 INSULATION �24 2�5 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. a/''TER HOOK-UP 17 SITE INSPECTION
= 05 FINAL dreoER HOOK-UO 06 PROGRESS
F` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS. •
cc OA,
cc
CC
W
W
CC
CCC WORK SATISFACTORY.PROCEED PROJECT COMPLETE
CC ❑CORRECT WORK R PROCEED 7 ISSUE CERTIFICATE OF OCCUPANCY
• ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
UO BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner!ContraF r on
Inspector.
White Copyllnspector's File Canary Copy/Site Notice