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Home My WebLink About1988- 001060 (well abandonment & replacement)PERMIT CITY OF ORONO PERMIT TYFb;C ‘C.*» IC'D 7 1 lATETC* 1335 Brown Rd. South • P.Q. BOX 66 Permit Nu Tihdr:bhWhh « WH 1fcn 001060Crystal Bay. Minnesota 55323 Date Iss'ed:07/28/88(612)473-7357 SITE ADDRESS: 1412 BALDUR PARK RO pin: os-117-2.3-34-00 us ____ DESCRIPTION: Sewer & Water Permit Type WELL Sewer & Water Work Type REPLACE EXISTING REMARKS: SITE MUST BE OKAY’D BY CITY STAFF. SUBMIT COPY OF STATE WELL RECORD. FEE — Etase Fee $.00 WELL Surcharge ___$..50 Total Fee taO.SO Subtotal $..50 CONTRACTOR:- Applicant —OWNER: STOOOLA DON WELL CO 49:382111 HAGFORS CURTIS 15306 HWY 7 1412 BALDUR PARK RD MINNETONKA MN .5.5345 WAYZATA MN 5.5:391 <612.'» 938-2111 THE UNDERSISNEC HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF - -ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. RMITEE SIGNATURE isr^fc BY: SIGNATURE U ABANDONED NELL RECORD I. louriai 0* Mcul County Mat Hennepin MINNESOTA UNIQUE HELL NO. (!■•«• bUnk If not kno^) rotmtnip Ntat To»nsnlp Nu^r RAngt Nuaotr S.ction No.FrACttoa % % of SW NE 4. HELL depth (coapitttd)0«tt siAltd 117 Jr S 23 y 08 SI K um Mcb I Strttt AdOrtst «nd City of u«M locBtlon or Olst«nci fro« Ro«d Inttrtoctlen 1412 Baldur Park Road Orono, Minn. ShO« tNBCt lOCNtlOn of woll (In uctlon grid nUii *l*) N S. OaiLLING H£TH00 (If kno»n) iQ Ciblt tool r Q Rovorst 7Q OHvtn ICQ Dug ZOHolloi*»od OAlr lO____ ^ aoUry &□ Jttttd Q Poiior Augtr Skitch Mp of Mil locNtlon . • t * . •• • ••• E T S-i. • I miU- 6. QBSTRUCTIOHS Util obllructod^ T« Obstnjctlont ^ ;«d^T#» □ no roMBNfd^Ttt Q No If obstructions CAnnot bt ^ rtaovtd, COntICt MOM b»forg stBllng. 7. use IJ^OoMStU 40 Monitoring 80 Ht«C Loop 20 10 Public S0 Industry 0 Tost Mfll 0Hunlclp«l l0Co*trcUl 0 Air Conditioning lQ_ 2, PROPCftTY OUNCR'S NAMC Curtis Hagfors Moiling Addrtss If differtnt mn proptrty Addross IndICAttd adoyo 1412 Baldur Park Road Omo j Mi nn _ rfARONCSS OF FORMATION LOG COLOR FORMATION FROM If not knot»n. IndICAtt fortiAClon log froa now votl or noirby tioll. 0. CASING(S) BlACk ZOCdWt 0 ThrtAdtd 0 Uoldtd 0PliStlc 0 StAlnItss Stftl ^ In. to ft. _____________In. to_______________ft. Sertontd util fm/S/ ft. to/Jo^t. 0Opon Holt . froa ___ ft. to ^ (If knoun) ft. 16. REMARKS* ELEVATION. SOURCE OF DATA • CASINGS REMOVED. CASINGS PERFORATED. ETC. 3" Well 135' Deep 3*s Hrs. Labor 4 Bags Conent 1 Bag Bentonite 10. STATIC HATER LEVEL _____________ft.JObtlO. 0AbO»t KP lAAd lurftet OiU MiASurkd / .‘Vo 11. WELLHEAD COMPLETION 0 PltUst Adipttr 0 Found lurltd 0Htll Pit 12. (^TING INFORMATION MutitCtatnt 0 8tntonltt Grout aattrltl froa/^Zto ft. cu. yds 13. HEAREST SOURCES OF CONTAMINATION fttt dirtctlon f typt Util disinficud btfort sttllng? 0 Ytt 14. PUMP ^Rtaovtd 0NotPrtstnt Typt; 10 Subatrilblt 0 L.S. turblnt 0 Rtclprocttlng ^Jit 4H CtntrlfuQtl eTl 15. EXISTING HELLS (Pltist skttcb locktlons cf ADtndontd And tctlvi vtlls In rtatrki stctl^ or on tick.) OlHtr unuttd «tll(l} on proptrtyT 0 Yti ^No Abindontd: 0 Ptratntnt 0 Ttaporiry 0 Not siiltd 17. HATER HELL CONTRACTORS CERTIFICATION This Mtll HAS sMltd undtr ay Jurisdiction «nd this rtport It trut to tbt bttt of ay knoaltdgt And btlltf. DON STODOIA WELL DRILLING CO.. INC. Llctnitt lullnttt Ntat Llctnst No. SFnCUl AWkOCMO VUL UC0«0 (My 6t ui.4 for FraMrty Triniftr) IMKMTtMTl HIM WZTM DBtB Addrtss 7r r - Slqntd^^^^^*a^AW*/w^-Ti^<^t^S^ j^Ottt 7—28—88 f of Orllltr 172 5345 DATE TIME CtTY OF ORONO INSPECTION NOTICE PERMIT NO________ CALLED IN SCHEDULED COMPLETED -?-zs-^ •2 : Zo ADDRESS OWNER _ • Ml ^1L!oe/^ TELEPHONE NO. _CONTR. Hi 55 i I § g 1 Uj 0:32 a: FOOTING FRAMING INSULATION WALL BO. FINAL PROGRESS DEMOL FIRE PREV. a PLUMBING Rl □ PLUMBING FINAL □ MECHANICAL □ WATER HOOKUP □ METER SET/TURN ON a SEWER HOOKUP □ SEPTIC INSTALL D SEPTIC MAINT. □ WELL TEST PUMP SITE INSPECTION EXCAV7GRADING/FILLING LAKESHORE/WETLANOS LICENSING COMPLAINT FOLLOW-UP SEPTIC FINAL FIREPLACEAVOOD BURNER COMMENTS: !3S ^ €>e^> t r\ A 8^22 iRK SATISFACTORY; PROCEED Q PHOTO TAKEN CORRECT WORK & PROCEED □ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING □ CORRECT UNSAFE CONDITION WITHIN HOURS INSPECTOR V;iLL RETURN n STOP ORDER POSTED. CALL INSPECTOR. □ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. ■ call for the next inspection 24 hours in advance.. Owner/Contr. Inspector;473-7357 White / Inspector's File Canary/Site Notice CITY OP ORONO APPLICATION FOR UTILITY PERMITS Box 66 (1335 So Brown Rd) SET^fiSR WATER WELL Crystal Bay, MN 55323 ************************i^************:k***«*«********************«********** General Instructions 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 City offices 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 *?n accordance with State Code requirements. 8. All work must be inspected before it is covered. Call 473-7357. 24 hour notice required. ***********i^*****ilr*«******«*** ******************************** ************* JOB SITE ADDRESS: /?!'f\ Occupancy Type:Resiaential Commercial OWNER'S NAME: _ _ _ _ _^ Mailing Address; r’jf _s"_. _ Phone No.: City: CONTRACTOR'S NAME: Bus. No.; Mailing Address; /Yu'y b City; Master Plumber's State License no.;City Cert. No.; PERMIT TYPE AND FEE CALCDLATION MUNICIPAL SEWER CONNECTION ($30.00 per stub) $ pipe size inches; material PVC (on sand fill);cast iron SAC Charge ($550.00) must accompany all sewer permit applications unless prepaid. If not prepaid, a sewer connection permit will not be issued. MUNICIPAL WATER CONNECTION ($30.00 per stub) $_ _ _ pipe size _ _finches; material _ _ copper; other_ _ _ _ WATER METERS must be picked up and paid for at City Hall. (5/8" meters = $95.00; 3/4" meters = $130.00) job) Repair Adandonment PRIVATE WELL INSTALLATIONS ($30.00 per Check; _ _ _^New _ _ _Replacement _ Casing size; _ _ _finches (Installation of new/replacement well covers abandment of old well. Well Abandonment - not concurrent with installation of new/replacement well requires a separate permit) REQUIRED minimum setbacks from drainfield and septic tanks = 75' CALL FOR A SITE LOCATION BEFORE DRILLING Upon completion. City must be sent a copy of State Well Record. *************************************************************************** 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 S 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;D.te=7'?T-<^'P DATE TIME CITY OF ORONO INSPECTION NOTICE PERMIT NO------- Hi i"t £ I § 0 1 § CC 2 Ujcc f2 IIsct Uj Q 8 yolpd CALLED IN SCHEDULED COMPLETED ^.22.-Sr2r ■5r-7'g I ADDRESS OWNER _ /^/^- <WkiO .CONTR. TELEPHONE NO. FOOTING FRAMING INSULATION WALL BD. FINAL PROGRESS DEMOU FIRE PREV. a PLUMBING Rl □ PLUMBING FINAL □ MECHANICAL □ WATER HOOKUP □ METER SET/TUHN ON O SEWER HOOKUP a SEPTIC INSTALL □ SEPTIC MAINT. □ WELL TEST PUMP □ SITE INSPECTION □ EXCAV7GRADING/FILLING □ LAKESHORE/WETLANOS a LICENSING a COMPLAINT □ FOLLOWUP □ SEPTIC FINAL □ FIREPLACE/WOOO BURNER □ ------------------------- COMMENTS: -----^---- \1------------------------- \ ______________________ \ □ WORK SATISFACTORY: PROCEED ° PHOTO TAKEN □ STOP ORDER POSTED. CALL INSPECTOR. □ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance --------------------------- Owner/Contr. on site^---------------------------------------------------------- I nspector "--------------------------- 473“7357 White/Inspector's File Car^fv /Site Notice tnmcf JUMIw.»AUw>iimiBtin«<City3l^ ----- ■■ ■ ■-^4 ■ -■ I iftm |i;V iig 'tr ■■' ii IK P BfcP i#i' pK-: tiAii »irM'T' SSS3SHsNsa I I • I I 1 ratsss m ■ I--''’ TT'VAffuaMr 1 ^===^==55^^ Ckic^ ito9£ors 1412 Baldnr iterk aoAd IliVaBtu, Mlim. 55391 rl« 168*8^36-«S nciMMrti IOMI mi# JbftMF Mllbwii ' «l«r . ' ' mitm :«l JUiMMiC StaM n «l«r [a KIM 4D IblMr . . ,,- m0i' '' «.~L^mm, •ki^ KIrsHn rnmtmimglmnr-:,:,.;,. 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