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Home My WebLink About2008-P12173 - sewer & water connect -•- PERMIT `CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: p12173 Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit (952) 249-4600 Date Issued: 6/17/2008 SITE ADDRESS: 764 Bridgewater Dr Unit# Long Lake,MN 55356 PID: 33-118-23-11-0110 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 70.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 70.50 . APPLICANT: Groth Sewer&Water OWNER: O.T. Development,LLC 775 Tower Drive 2670 Kelley Pkwy Hamel,MN 55340 Orono,MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � � PPL[CA PERMITE IGN E IS ED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l FOR CITI'USE ONLY �O;¢(�,j O\ City of Orono Date Received: Permit# `�` P.O.Box 66 �� ,;; � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed � ,i,��r�,,:�. �. Crystal Bay,MN 55323 '�'?�n��y,G` (952)249-4600 Approved By(IfRequired): � �t??�Q��'� `— __- CITY OF ORONO-SEWER & WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERM]TS- Mav be subiect to further review and m�v not be issued when thc anplication ic received) GENERAL INFORMATION 1. You may apply for utiliry permits by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by return mail within 2 business days. 3. Permits are not valid until you receive a permit card. 4. Wark 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. Contaet the Public 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 Public Works Department. Issuance of a permit does not grant this approval. 7. All worh must be done in accordance with State Code requirements. 8. All �vork must be inspected before it is covered. Call (952)249-4600,24+hour notice required. TYPE OF PERMIT (Check All That A 1 ) �Residential (May Require Approval) � Commercia](Approval Required) �New Connection �Additional Connection � Re-Connection � Repairs �Disconnect Job Site/ Owner Information: Site Address: � �P t 1 � � � �-�` Owner:��-�0�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Infonnation: � Contracto .• " `�l ��'�-� Contact Person: C � r--�-- �7 G Address:� �� / !��l2-- �tate License#: _� l � �-- City: �l� Zip�7 7�y�piration Date: �� U � Phone:�� 7� �7� �`I Alternate Phone: � l�� 7 / ` DETERMINING PERMIT FEES � SAC Charge(2007 Rate=�1,675.00) � (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) "�,Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ Pipe size inches;material�Sc�air tested; � cast iron � �Water Conn ction/Disconnect/Repair($35.00/Per Stub) $ Pipe size�inches;material Schd 40 air tested; 0 copper �� 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATION -WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter installation. 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 mad on this application are, true and correct. � Applican : Date: � � � Reset For % / D TE TIME �/ CITY OF ORONO CALLED IN ��Z� INSPECTION NO ICE � SCHEDULED -/ -D � PERMIT N0. /02 � 7 COMPLETED ADDRESS ��07 ,(3 r c dc�e�vc�.�, �J OWNER CONTR. ��`�� TELEPHONE NO. � DESCRIPTION �E� � ��" �� J � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING � ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREP�ACE ❑ TREE REMOVAL Z ❑ WALL BD. � WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � w a � .�"i h TC��-_�� 0 � � 0 � W � Q � z W � W � � d W� ❑WORKSATISFACTORY:PROCEED Ci PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR J CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� 2Q9-46QQ OwnerlContractor on site: Inspector. � .! � �L� White Copylinspector's File Canary Copy/Site Notice