HomeMy WebLinkAbout2003 - P06903 - sewer/water connect Al PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P06903
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 10/16/2003
SITE ADDRESS: 870 Willow View Dr
Long Lake,MN 55356
PID: 28-118-23-44-0015
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: RVC Homes
5089 Shoreline Drive 1003 Twelve Oaks Circle
Mound,MN 55364 Wayzata,MN 55391
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.
(4/14-)
APPL�A 0PERMITEE SIGNATURE / / ISSUED BY SIGNATURE
Copies: 1-File(Siinitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
(Updated 6/2/03)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS f06?V.
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 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.
JOB SITE ADDRESS: .21 0 i ' \I\ `- i V e`,.� f�`-
Occupancy Type: '� Residential Commercial
Owner's Name: .1) C '-k-o o, e- Phone Number:
Mailing Address: City: Zip:
Contractor's Name: CoQ Q \ cam) S 9-"v Phone Number: ct. -� 1f 7 . Z3I b
Mailing Address: Co 9 S 1,,,z3 �(.. t- ,- e_ C)— City: /17 o c i hi Zip: S S 5 f
PERMIT TYPE ig'C;onnections ❑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 onnection/Disconnect/Repair($35.00 per stub) $
pipe size Et( inches; material p(C-Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/R•($35.00 per stub) $
pipe size I u inches; material /c/ 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 ordinancesif the City and the regulations of the State of Minnesota, and certifies that all statements
made on this application areplete, truean• orrect.
Signature of Applicant: .,.IA JdL L....41014/./ Date: ( o ,e73
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �p
PERMIT NO. pD 1010 3 COMPLETED - 67 t4,
ADDRESS CPO £A I(o`--- U
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
14, 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORENVETLANDS
H 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 07 ATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 40• SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS: L
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W WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
C) 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
u BEFORE COVERING
PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for thej' xt inspection 24 hours in advance. (952) 249-4600
OwnedContr. • (i'' ite:
Inspect/ I ,
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