HomeMy WebLinkAbout1996-008233 (sewer & water) � - PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �=;�:i�;-;�� F:, ;�;�j���,
Crystal Bay, Minnesota 55323 Permit Number: •:= _ ,._._.-
�'��'�_-.•� , -
(612) 473-7357 Date Issued: � �:��y�� .
i�;�.j;,:.�°�tt�.
SITE ADDRESS:
��.%`�_� ���=�Y'<<Z��� �ii?
L'=;V
�' . 3 . P�#. � t_��—#. � :'—_.._—1 :�—E_:+�i j,:�.
DESCRIPTION:
�.F�:��:� «�t::,rW;����:.:����i��1
��'tyF'j' s? �,4:��.�?1' h'`?�.1'(€'i 1 f.' i y���' `_`.:'A���; '_-=-�I��E���[:��l,ii�;
�.�_3iJN) ;�� f,c�:_{'�•�F' ��_ii'�:; I �r��F� ��:W:��,:�,�`y;r.r_,�—_
REMARKS:
FEE SUMMARY:
������ Fe� �=;.� , i;�; t1r��Il_ i��3 _______-- ����_}
==_.I;`CI-3�i1'`�?- '#s ,.-.�m'tAl ���s�.�i �w+f• .r
--____.�.___ 1 ��=,7 ,iyii
;�1,34�a i.���t..�i �::; . �t}
CONTRACTOR: _ �:;�,C,� �;�,-,t. _ OWNER:
�:a1 I Gi'1i�i={ I t��t� ':�:�1.�.�.��1 �.`�� tJ��°_�i r.�D T _1�f=sl-lt��
F'fi �:i=iX �i'� ��� (�i F:��:=�i[;� �'fi
=;"i" E�f��i�IFr�i;Iil:=; ���•.; .�.5=,:%5 t�li�E�Ei�li� fi1t�1 �.�_:��.
t:r,j,y� i ,���,.r,—�.c�.��iG t:��i�`:)d.�—t_)'_:r«!.
��-�� t 1��Ilr�°v�I r:;,viwi! �-i;�R��:Y' t�:�c;�i 1�°<<'i`= F`;�;��_;�°=�°�;T.�irt� -�,�� i����fi�::;�= Ti-it� t=°�Eai_ i�•;�=°�,i=��JE;•f������i';
�='�'��:.L:��' i L[.3 ��t�'°w�i ,'r:;t�Fi k-,E-,.�� �(i,,,l I�)I_,i {�'i I_� it�!_,!ri 1�;_ T�y :� 1 {:'��, � L..1_i!Y!�''t_.�f'i�?{.� ;.�1��I-? �'t��„ (,:� ': i_:�
L i���=�°iii•���a ;;�;�,itdt��1��:,_:=� F=�t�1�_� ��Tt�T��. s��l= h1.tt�la�v�°��ii7� �it�IL�i�`��� �_i.1�i� �'��zs!_1I#;��li�.tuT°=� . �
`�-�22Fx,� �.� - � ��,/�;'� �� f,�.�-�,
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
' CI'1'Y UF ORONO APPLICATION FOR UTILITY 1'ER11�I1'1'S
13ox GG (2750 Kelley Parkway) S�WER/WAT�R
Crystal Bay, MN 55323
GENI;RAL INFORMA'f10IY
1. You may apply for utility pennits by mail or in person at the City officcs.
2. Mailed in applications are subject to thc postage and handling fees shown bclow. Pennit 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 tlie 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(473-7357)for utility stub as-built locations. DO NOT EXCAVAT'G
1N ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works
Departmcnt. Issuance of a permit does not grant this approvll.
7. All work must be done in accordance witll State Code requirements.
8. All work must be inspected before it is covered. Ca11473-7357.
24 hour notice required.
JOBSIT�ADDI�SS: 3 " D � �
Occupancy Type: I�csidenti� Commercial
Owner's Name: � � � " Phoiie Number: ����- - f � _-'s Y
Mailing Address. ` ���� - �' � City: 5 � �:> � ��. 7�p:
Contractor's Name: �/ �- , �- Phone Number: �,1�� /y ys '
Mailing Address: � .� 3 S— City: �= " 7�p: �-5� ZS
P�RMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size �/� inches; material_�PVC (ou saiid fill); cast� iron
SAC Charge($850.00)must accompany all sewer petmit applications unless prepaid. If not prepaid,
a sewer coruiection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
WA'I'LR ME'I'ERS must be picked up and paid for at City I-lall.
(5/8" ineters = $139.00; 3/4" meters = $191.00; 1" meters = $247.00)
Separate Plumbing Permit issued for water meter.
Watcr meters must be set and sealed by Orono Water Departcnent(473-7357)upon completion
of mcter install�tion.
RCQUIREll minimum setbacks from draiiirield and septic tanks = 75'
RCQUIRCD setback from sewer line = 20'
PF,IZMIT FCI; CALCULA'TION
1. Subtotal of above permit requested $ "'` � �
^ 2. State Surchar�e $ .50
�, The State I3uilding Code Division Surcharge of$.50 per permit must be
, ;
^ included for each well,sewer and water connection permit requested.
'���� 3. Posta,ge & Handling (Only mail-in applications) $ 1.50
4. TOTAL P�RMIT FLE (add lines 1-3 above) $ ; ? '
1'he 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 slatements made on this application are complete, true and correct.
Si�;naturc ofApplicant:����/���-�'a�Ii��� Date: �'' �S ' ��
✓
DATE TIME
CITY OF ORONO CALLED IN ' � �
INSPECTION NOTICE SCHEDULEO % ��= -��
PERMIT NO. �.d 3 3 COMPLETED
ADDRESS ' - ��!� . �,
OWNER ' CONTR. - � • �_
TELEPHONE NO. f '
� DESCRIPTION
� 01 FOOTINCa 11 MECHANICAL RI 18IXCAV/GRADINO/F�WNO
y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/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-UO ' 06 PROGFiESS
� 07 DEMO—SITE 27 SEPTiC MAINT. 21 COMPLAINT
J
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FlNAL 35 HARD COVER REMOVAL
� 10 PLUMBIN(3 FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YO : Y S NO
� COMMENTS: '
¢ �,,,
W
C
�
J
O
>.
�
O
�
W s' 4'� V�C�
�
Q
�
z
W
�
W
�
�
d C WORK SATISFACTORY:PRO �' Ir
W C PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATfON ISSUED
❑ �NSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next i spection 24 hours in advance.473-7357
OwnerlContra n s e
Inspector. �
White Copy/inspector's File Canary CopylSite Notice