HomeMy WebLinkAbout1993-005089 (sewer connection) .
� PEI�MIT
CITY OF ORONO PE�RMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 �_�E:.��:'�_4 ��{ �E����=�
Orono, Minnesota 55356-0815 Permit Number: r_;�:;,;;::�;_�,�
(612) 473-7357 Date Issued: - -
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APP�ICANTiPERMITEE SIG ATURE ISSUED BY:SIGNATURE �
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_. _ _, _ _ :
• CITY OF ORONO APPLICATION FOR DTILITY PERMITS a
Box 66 (1335 So Brown Rd) SEWER WATER
Crystal Bay, MN 55323 '
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I: You majy�pply�or 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�.anits are n�t va.lid umtil you reoeive a �*Th;t 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 (473-7357) for utility stub as-built locations.
DO NOT �CAVATE IN ANY SIREET AND DO NC7r TAP ANY MAIN without express approval of the
Public Works Departsnent. 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. Cal 1 473-7357.
24 haur natioe requirec3.
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JOB SITE ADDRESS: C /
Occupancy Type: G%" Residential Commercial
OWNER'S NAME: ��j c� J;�=�l ,/L�'��iZ����il,j Phone No. :
Mailing Address: City:
CONTRACTOR'S NAML: l- '��� L 1�-� %�'_'��� Bus. Phone: `���� ������-�'
Mailing Address: City: / �! Zip: �:�"�;'��-
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PERMIT TYPE AND F$E CALCIII,ATION �
MIINICIPAL SEWER CONNECTION ( $30 . 00 per stub) $ � � '�r� '
pipe size // inches; material �PVC (on sand fill) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless 'f
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 '
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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 PERHiIT FEE (add Iines 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, a,�d ce�ifies that all statements made on this �
application are co�lete, true and.�corr�'. �
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Signature of Applicant: ' �y_-� �E-=� Date: �� '� `�` � � ?
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qATE TIME
CITY OF ORONO CALLED IN � �'
INSPECTION NOTICE SCHEDULED S `'3 / �'3�
PERMITNO. `�C �' � COMPLETED
ADDRESS S
OWNER ��.Z��v � CONTR. C
TELEPHONE NO. .
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q 05 FINAL 13 MET ON 17 SITE INSPECTION
� 07 DEMO—SITE SEWER HOOK-UP� O6 PROGRESS
`� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
2 09 PLUMBING RI 15 SEPTIC iNSTALL. 22 FOLLOW-UP
J 10 PLUMBiNG FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES NO
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� COMMENTS:
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d `�,WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W �L� CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTI N TEMPORARY
� BEFORECOVERING PERMANENT
C7 CORRECT UNSAFE C HO
INSPECTOR WILL REfURN �- PHOTO TAKEN
�S� �i C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARP.ANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on ite:
Inspector. ��
White Copy/lnspector's File Canary Copy/Site Notice