HomeMy WebLinkAbout1994-006343 (sewer & water) T PERMIT
VITY OF ORONO PERMIT TYPE:
275o Kelley Parkway • P.O. Box 815 Permit Number: '� `'�`��` -� `�!r' ` �=�`'
Orono, Minnesota 55356-0815 '-''-`'�°�=������= I
(612) 473-7357 Date Issued: -
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �GG� �.
� CITY OF ORONO APPLICATION FOR UTILITY PERMITS ��;���3
� Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
GENERAL INFORMATION
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 pernut 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 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 in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 hour notice required.
JOB SITE ADDRESS: � �� � �Y- c'� �� •
Occupancy Type: Residenti Commercial
Owner's Name: �.ti� c�.�ti� � `���
��-. �.,,�,�.� PhoneNumber: 4��- z � _ �°���
Mailing Address: � �� � � City:�T,+�,,� �-�- �p: � sy�
Contractor's Name: ' PhoneNumber: hJ7� -:�3�r�;
Mailing Address: `3 C:� �ti.�=-{,._ City: �-�_ _ �. 7ip: ����
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) �
pipe size � inches; material PVC (on sand fill); �_ cast iron
SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) �
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at Ciry Hall.
(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
VVater meters must be set and sealed by Orono Water Department (473-735'� upon
completion of ineter installation.
REQUIRED minimum setbacks from drainf'ield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
l. Subtotal of above permit requested �
2. State Surchar�e � •50 �
The State Building Code Division Surcharge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta�e & Handlin� (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.
`_' ' Dale: �' /�,'��'�
SiQnature of Applican� _
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED
PERMIT N0. ��..��� COMPLETED R'I ' �1 I I�y5
ADDRESS �S �u4tsS��
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTINCi it MECHANICALRI 18EXCAV/GRADINQ/FIWNG
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAi�SHORElWETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE tNSPECTION
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Z 05 FINAL 1�,y�EWER HOOK-UO O6 PROGRESS
~ 07 DEM�-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION HEMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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d�WORKSATISFACTORY:PROCEED �\ �PROJECTCOMPLETE
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� L] CORRECT WORK&PROCEED i= ISSUE CERTIFICATE OF OCCUPANCY
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O C; COFiRECT WORK,CALL FC�R REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDII�IONWITHIN HOURS. �-, pHOTOTAKEN
INSPECTOR WILL RETI�RN
❑STOP ORDER POSTED.CALL INSPECTOR
� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContracto si .
Inspector.
White Copyllnspector's File Canary Copy/Site Notice