HomeMy WebLinkAbout2000-P02867 - sewer/water connect PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P02867
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(612) 249-4600 Date Issued: 8/23/200
SITE ADDRESS: 2380 Shadywood Rd
WAYZATA,MN 55391
PID: 17-117-23-44-0006
DESCRIPTION:
Proposed Use: Commercial
Permit Class: General
PermitType: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
Water Connection
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: VOSON PLUMBING OWNER: WALFRED PROPERTIES
1515 A 5TH STREET SOUTH 5100 EDEN AVE SUITE 112
HOPKINS,MN 55343 MINNEAPOLIS,MN 55437
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.
PPLICANT PERMITEE SIGNATURE ISDBY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
_ 0
CITY OF ORONO APPLICATION FOR UTILITY PERMITS 0 5 I a'
Box 66 (2750 Kelley Parkway) SEWER/WATER 1 b�
Crystal Bay, MN 55323 cl0 id'
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.
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24 hour notice required. 11
JOB SITE ADDRESS: r2 S{lud���cv� z()
Occupancy Type: Residential Commercial
Owner's Name: Phone Number: 9SZ' 93
Mailing Address: City: . v0c,ih 5 Zip: 5534.13
Contractor's Name: \16,50N P 1u,mVits zA t_ Phone Number:
Mailing Address: \c;.--Ls- A- c4-►. ST S City:
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $ WO
ri„.ipe size L inches; material X 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) $ � 04,0pipe size 1p inches; material copper; other Dip
WATER METERS must be picked up and paid for at City Hall.
Water 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: