HomeMy WebLinkAbout2003 - P07103 - sewer/water connect PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07103
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 12/17/2003
SITE ADDRESS: 865 Willow View Dr
Long Lake,MN 55356
PID: 28-118-23-44-0005
DESCRIPTION:
Proposed Use: Residential
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:
FEE SUMMARY: Permit Fee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Coppin Sewer&Water OWNER: Brenshell Homes
5089 Shoreline Drive 4052 Oakland St E
Mound,MN 55364 St.Bonifacius,MN 55375
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 —
/ ISSUED BY SIGNATURE
Conies: 1-File(Si&nitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
(Updated 6/2/03)
CITY Of' ORONO APPLICATION FOR UTILITY PERMITS -
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
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 fee 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 maybe 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.
JOB SITE ADDRESS: 2((--)S Lam' ' w 0 C
Occupancy Type: Residential Commercial
Owner's Name: 'Qjre,t5\1e\\ Phone Number:
Mailing Address: City: Zip:
Contractor's Name: Cx) Q Q Phone Number: S), 41)-.• V
Mailing Address: S o 84 S\-\o c L\\^e Q,- City: CO r.1 Zip: Ic 3b`!
PERMIT TYPEonnections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,275.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair($35.00 per stub) $
pipe size inches; material Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size 11 inches; material 'IL copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
(952-249-4600) upon completion of meter installation.
REQUIRED minimum setbacks from drain field and septic tanks=75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surcharge $ .50 (Minimum)
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 (Mail In Only)
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 ordinanc s of the City and the regulations of the State of Minnesota, and certifies that all statements
made on this application are omplete,, e and correct.
Signature of Applican : C i - Date: j )' 17- 0 3
DATE TIME
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CITY OF ORONO CALLED IN I)^1 /-3
INSPECTION NOTICE SCHEDULED /a o2'/-Q' I• O
PERMIT NO. PO 71D' COMPLETED 11-2`i- c; i`., G
ADDRESS (Ao S GV A k InJ U, .I,,,,./ 0
OWNER CONTR. C pi)✓\
TELEPHONE NO. - 1'- - (94 D (99-as d CC e-
C,y
DESCRIPTION V--�
IQ 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
CI) 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 2 WATER HOOK-UPJ 17 SITE INSPECTION
05 FINAL "ER-4400K-UP 06 PROGRESS
07 DEMO-SITE 2 "' „_ . 21 COMPLAINT
✓ 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
OWNER/CONTRACTOR TO MEET YOU: YES_NO
CICOMMENTS: — \--,-,$r= f1 ,r-. j
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/IQ 0 WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W 0 CORRECT WORK&PROCEED ❑ IS.8UE CERTIFICATE OF OCCUPANCY
0 CICORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.) BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
El
CI STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner!Contracor on site:f (' ' t -_
4
Inspector. ''i a r S .
White Copy/Inspector's File Canary Copy/Site Notice