HomeMy WebLinkAbout2001-P04122 - sewer/water permit C I'Tlf'_�)F O RO N O PERMIT
Permit Number:
2750 Kelley Parkway - PO Box 66 P04122
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 7/25/2001
SITE ADDRESS: 825 Willow Dr S
Wayzata, MN 55391
PID: 10-117-23-22-0001
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution 4:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Sullivan's Utility Services, Inc. OWNER: Phyllis Fadden
3660 Hwy 101 S 825 Willow Dr S
Wayzata, NIN 55391 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.
I I NAT ISSUED BY SIGNATURE
Copies: 1-File(Signitura Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, I-Finance Pagel
(U,-dated 2/12/01)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWERIWATER
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: a S^ 6,J,1/0c j )9ri
Occupancy Type: E/ Residential Commercial
Owner's Name: p�„���'S ,� Phone Number: 1-17 3 - 89-2 8
Mailing Address: -,S ` City: 0\1-,n v, C, lip: S� 3
Contractor's Name: Phone Number: 436a
Mailing Address: City: Zip: 10 J
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size111* inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00)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.
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
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 stateme is made on this application are complete,true and correct.
Signature of Applicant: Date: 2 z�-� l
CITY OF ORONO CALLED IN
INSPECTION TI�F�, SCHEDULED III
PERMIT NO. B 1 I LZ COMPLETED
ADDRES ��� U)-I L)bt�
OWNER �� �r1 CONTR. ' Va^S,
TELEPHONE NO." SOS -4%14,i
DESCRIPTION Se w e r �,a,)k �--+1 �
~ 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURN ER/Fl REPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 4 SEWER HOOK-UP j 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO ME Y :_YES_NO
COMMENTS: S S�CI✓I
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SATISFACTORY:PROCEED �pROJ CT COMPLET
LU ❑CORRECT WORK&PROCEED /❑ISSUE CERTIFICAT OF OCCUPANCY
El CORRECT WORK,CALL FOR REINSPECTION TEMPOR RY
C1 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. (952) 249-4600
Owner/Contrac r on site:
Inspector.
White CopylInspector's File Canary Copy/Site Notice