HomeMy WebLinkAbout1993-005053 (sewer & water) _ __ _ _
P I�MIT
CITY OF ORONO ' PERMIT TYPE: ,_;�.��:� �, ��F:�..L�
2750 Kelley Parkway • P.O. Box 815 Permit Number: �
Orono, Minnesota 55356-0815 `-"-'�='�`����
(612) 473-7357 Date Issued: 4,�f� �:;,�,;_;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIG ATURE ISSUED BY:SIGNATURE �,��,
CITY OF ORONO �� �• ' APPLICATION FOR UTILITY PERMITS '
Box 66 (1335 So Brown Rd) .- - SEWER WATER
Crystal Bay, MN 55323
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I: You mal�pply�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. P�nnits are mt valid imtil you reoe.ive a pemnit c�rd.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permi.ts may be issued to licensed contractors only.
6. Contact the Public Works Department (473-7357) for utility stub as-built locations. :;
DO NOT EXCAVATE IN ANY SZREET AND DO NOT TAP ANY MAIN without express approval of the ;
Public Works Depart-ment. Issuance of a permit does not grant this approval.
7. All work must be done in accordance with State Code requirements.
8. Al1 work must be inspected before it is covered. Call 473-7357.
24 haur notioe rec��;red.
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JOB SITE ADDRESS: s� ��� �S '� i � ��J<< ��v�
Occupancy Type: k Residential Commercial
OWNER'S NAME: i�,�-'�'1�j��T- /-f,r�/�� Phone No. :
Mailing Address: �, ; �r s,- �7 � y ;-� r.�,�,�- �� z� City: �� �1 ����� �,
CONTRACTOR'S NAME: ���'' 2� i� �x`�� S��! Bus . Phone: `/�;' � `� ����'
Mailing Address: -�.> ,� %1�7i.>7 �,--�c City: �•�� e� '��<.- Zip: ��:� ���
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-_ PERMIT TYPE AND FE$ CALCULATION
MUNICIPAL SEWER CONNECTION ( $30. 00 per�tub) $ �3 �5 ��'
pipe size inches; material `iPVC (on sand fill) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless ``�
prepaid. If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WATER CONNECTION ($30. 00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133. 00 ; 3/4" meters = $181.00; 1" meters = $235. 00)
Water meters must be set and sealed by Orono Water Department (473-7357) '�
upon completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75' �
;
REQUIRED setback from sewer line = 20 '
*****************************************************************�********* :'
1. Subtotal of above permit requested $ "� � � �
2. State Surcharge . 50
The State Building Code Division Surcharge of .50 per permit must e
included for each well, sewer and water connection permit requested.
3 . Postage � Handling (Only mail-in applications) $ 1. 50
_� � - ,�, ��
4. TOTAL PERIKIT FEE (add lines 1-3 above) $ � �
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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 d c�r�
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Signature of Applicant- �>���� . / -< � Date: L� �"� 1� � � J
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DATF_ TIME
CITY OF ORONO CALLED IN d -I� -q 3
INSPECTIAN NOTICE SCHEDULED � -r�
PERMIT NO. S�S � COMPLETED �—�� �=c�.7 D
ADDRESS ��`��
OWNER � CONTR. �C,��l ���� -�' vl�
TELEPHONE NO. �7 � " ��'G'S
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANOS
Q
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETlTURN QN 17 SITE INSPECTION
� 07 DEMO—SITE �EWER HOOK-UP 06 PROGRESS
v 07�EMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNEH/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W L�WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W �❑ CORRECT WORK&PROCEED ��, ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. f- pH0T0 TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor�,�site
Inspector. - U' ^I,
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. MPLET o
ADDRESS �3L �
OWNER CONTR. �
,
TELEPHONE N0.
� DESCRIPTION JS -� �I�� � � ` {' J�
LV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLWG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 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-StTE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBIN 36 FOUNDATION/REMOVAL
� OWNERI ORTOMEETYOU: YES NO
� COMMENTS: "� 9�'`I-i!�
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d ❑WORK SATISFACTORY:PROCEED ��) PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
C7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473�73�J7
Owner/Contracto" s' :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
CITY of ORO�O
Buildin Permit PERMIT NO. 6050 �
g � �,
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY �ATE ISSUE� � � f�
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING DISTRICT "' `� ,L , � � ,
SITE ADDRESS � � :r I
PROPERTY IDENTIFICATION NO.(PID) � � �� �
FIRE DEPARTMENT LOT BLOCK SUBDIVISION
POST OFFICE OWNER (Name) � � : (Address) . (Phone)
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� ��1:� L-i,��� �� l_ —t �� '� � ��� � - � �� -
VAR. DATE ARCHITECT/ENGINEER- Must Certif Multi-Fa
y y,Commercial& Industrial Construction Plans
(Firm) (Address) (Phone)
COND. USE DATE
LO AR A BUILDER (Firm) (Address) ,�7 r �, (Phone)
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WI�T � DEPTH � 1 t' i �i;-��:'� � %IC� �. � ���� ��%��_�:a.�r�.� � h�- _.
TYPE OF� ORK New Addition Remodel \enovate �'
1 �-�C_
PR P ED SETBA� ,�� .
FRO T . SI /��-� '''� / ,-�—
REA SI E CONST.TYPE BUILDING SIZE Esti ated Construction Valuation
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LAKE ETLANDS
OCCUPANCY PERMIT FEE
CLASSIFICATION � �C C'�
ACCESS DWELL STORIES g � 2 3 BLDG. PERMIT � ' � �
UNITS STATE FEE �� � /`�
NEW EXISTING GAR.STALLS NUMBER OF BEDROOMS
AGENCY-APPROV. DATE q� PLAN REVIEW
CITY DET. SEPTIC
APP. DATE SAC CHARGE
COUNTY PROPOSED USE SEWER UNIT
STATE PARK FEE
PENALTY
PRIVATE EASEMENT COUNCIL
APP. DATE OTHER
TOTAL DUE / �, �
REMARKS: L
INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT
SEPARATE PERMITS THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
❑ . . . . . . FOOTING before pour
❑ . . . . . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DEC�ARES
❑ . . . . . . INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
•. . . . . .
WALLBOARD before taping ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE-
WELL ...............................
. . . . . . FINAL before occupancy
❑ . . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER-
WORK BEYOND OR WITHOUT A RE- SEWER.............................. � SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM-
QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
JECT TO PENALTY. WATER..............................
OF MINNESOTA BUILDING CODE REQUIREMENTS.
GRADING 8 FILLING ............... ❑
INSPECTIONS MUST BE CALLED-IN -. , , i
24 HOURS IN ADVANCE. FIRE................................. ❑ � / ��,�y,
Signatur -:
/ '"������1l� � Date / ' � ��s
COPY:WHITE-FILE GREEN-FINANCE `
CANARY-INSPECTOR GOLD-RECEIPT /�._ ` �� '7`� 1
PINK-ASSESSOR Approved` " G� City of Orono
Brooklyn Prtg.&Adv.Co.Inc (6721 561-4470 —