HomeMy WebLinkAbout2000-P03103 - sewer connection -CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: P03103
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(612) 249-4600 Date Issued: 10/1020
SITE ADDRESS: 1850 Fox Ridge Rd
LONG LAKE, MN 55356
PID: 03-117-23-13-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 500.00
State Surcharge Fee: $ 0.50
SAC Fee: $ 1,100.00
TOTAL FEE: $ 1,135.50
APPLICANT: RITTER EXCAVATING OWNER: M C HEADRICK&L S HEADRICK
7120 VERNON STREET 1850 FOX RIDGE RD
ROCKFORD,MN 55373 LONG LAKE MN 55356
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.
APPLI 'ANT PE EE SIGNATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Pagel
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
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(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 249-4600.
24 hour notice required.
JOB SITE ADDRESS: •� �� �
Occupancy Type: Residential Commercial
Owner's Name: Phone Number:
Mailing Address: C O z City: Zip:
Contractor's Name: ��hone Number: r477-- 5
Mailing Address: city:/ '�'�-- tiP: L:�-_77 j
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,100.00) 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.
`Vater meters must be set and sealed by Orono Water Department(249-4600)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.
Signature of Applicant•_ �'�'�'''""`'` ��— Date:
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N�OTICE SCHEDULED 10`IIE-cc
PERMIT NO. !JIL Aj �3 COMPLETED
ADDRESS fo X Kj�
OWNER r�PG(Iv�( ,.0 CONTR. 121 Ike
TELEPHONE NO. 6/
DESCRIPTION f(�c,2 7Z C.CC;7� 7(% M_
W 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP- 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
OWNERICONTRACTOR TO MEET YOU:_YES NO Allk_
COMMENTS:
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El WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. I PHOTOTAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for nex;:, 249-4600Owner/Co
Inspector. 7,c1ion24hou.,sina_dvance,
White CopylInspector's File Canary Copy/Site Notice