HomeMy WebLinkAbout2004-P08062 (Sewer & Water - connection) PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelle y Parkwa y - PO Box 66 Poso62
Crystal Bay, Minnesota 55323 Pet'mit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: ioii2�2oo4
SITE ADDRESS: 1444 Baldur Park Rd
Wayzata,MN 55391
PID: 08-117-23-43-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
SAC Grandfathered In#1472 -OS/67
FEE SUMMARY: Permit Fee: $ 35.00 Vatuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Widmer Construction LLC OWNER: Patrick&Loring 7 Kaveney
9455 County Rd. 15 1444 Baldur Park Rd
Maple Plain,MN 55359 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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� APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-ApplicanL 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
(Updated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
.
Box 66 (2750 Kelley Parkway) SEWERJWATER& SAC
Crystal Bay, MN 55323 �
GENERAL INFORNIATION
1. You inay ap�ly for utility pennits by mail or in person at the City offices. {
2. Mailed in applications are subject to the postage and handling fee shown below. Pernut cards �vill 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 peinut card is available on the job site.
5. Utility comiection pernuts may be issued to licensed contractors only.
6. Contact the PuUlic 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 PuUlic Works Deparnnent. Issuance of a pemut does not grant this approval.��
7. All�vork must be doue in accordauce with State Code requirements.
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8. All work must be inspected before it is covered. Call(952)249-4600, 24 hour notice required. �>- ,^
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JOB SITE ADDR.ESS: �� .�,
Occupancy Type: �� Residential Commercial ,�` �`
Owner's Name: ,�',��f°-��,� k'����� =-��=�- Phone Number: �1"�-��� ���/� �_.�� ���
Mailing Address: .C� City: Zip: �
Cont�-actor's Name: C:.s�"��M� G�������'��«��.2. Phone Number: %s.� - �s�� -,5.-c�.�
Mailing Add►•ess:_�ys-s c�s �� /�� City:i�>,��'l fi�z.� Zip: s s��y
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PERMIT TYPE Comlections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,350.00) � (Set Rate)
Sac Charge tnust accompany all sewer pennit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Co�inection/Disconnect/Repair ($35.00 per stub) $
pipe size���inches; material�Schd 40 air tested; � cast iron
Municipal Water Connection/Disconnect/Repair ($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
(9.52-249-4600) upon completion of ineter installation.
REQUIRED minimtun setUacks frorn drain field and septic tanks = 75'
REQUIRED setback fi-oin sewer line = 20'
PERMIT FEE CALCULATION ;
1. Subtotal of above pennit requested $
2. State Surcharae $ .50 (Minimum)
The State Building Code Division Surcharge of$.SO per pernlit must be -
included for each well,sewer and water connection pernut requested.
3. Posta�e & Handlin� (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 ordinances of the City and the regulations of the State of Mirulesota, and certifies that all statements �
made on this application are co�lete, true and correct.
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Signature of Applican�-''�� ��-'�����-���� Date: �C% %'� �O��
� �� DATE TIME
CITY OF ORONO • CALLED�N �U'I�'� _�
INSPECTION NOTICE SCHEDULED C��� �-'''L�
PERMIT NO. U�U� Z COMPLETE I ��
ADDRESS � I /' �G`l��C t�.
OWNER CONTR. G�����/�
TELEPHONE NOI��Z�o I �CP�(�
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� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. ]�A�E - 17 SITE INSPECTION
Q 05 FINAL �� 14 SEWEBNOOK-UP 06 PROGRESS
� 07 DEMO-SITE . 21 COMPLAINT
� 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
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
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W ❑CORRECT WORK R PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN
INSPECTOR W4LL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
Owner/Contractor on site:
Inspector.�" �` `�%�
White Copyllnspector's File Canary CopylSite Notice