HomeMy WebLinkAbout2006-P10316 - sewer & water � PERMIT
ClTY OF ORONO
Permit Number:
2730 Kelley Parkway- PO Box 66 P10316
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued:
9/13/2006
SITE ADDRESS: 780 Bridgewater Dr Unit#
Long Lake,MN 55356
PID: 33-118-23-12-0024
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Pernut Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Groth Water&Sewer OWNER: O.T. Development,LLC
775 Tower Drive 10300 lOth Avenue N#101
Hamel,MN 55340 Plymouth,MN 55441
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 R�QUIREMENTS.
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AP L[CA PERM EE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
���` City of OI'ono Date Receivedi Permit#
"r P.O.Box 6G
��; � 2750 Kelley Parkway ❑ in-House SAC Determination Form Completed
a '����.'.� �. Crystal Bay,MN 55323
�� �;' � r� o` 952 249-4600 Approved By(If Required):
t�1�w���� ( )
CITY OF ORONO —S�WER& WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or PuUlic Works Department*)
(ALL PERIIIITS- Nlav be subieM to further revicw and mav not be issued when thc anniication is received)
GENERAL INFORMATION
1. You may apply for utility pennits by mail or in person at the City offices.
2. Mailed in applicarions are subject to the postage and handling fee shown below. Pernut cards will
be sent by rehn-n mail within 2 busuiess days.
3. Pei-mits are not valid until you receive a pernrit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility coiulection permits may be issued to licensed conri�actors oi�ly.
6. Contact the Public Works Department(952-249-4600) for utility shib as-built locations.
DO NOT EXCAVATE I'ANY STI2EET AND DO NOT TAP ANY MAIN�i�ithout express
approval of the Public VVorks Department. Issuance of a pernut does not grant this approval.
7. All work must be done in accordance with State Code requirements.
S. All work inust be inspected before it is covered. Call(952)249-4600,24+hour notice required.
TYPE OF PERMIT
(Check All That Apply)
�Residential(May Require Approval) ❑ Commercial(Approval Required)
�New Connection ❑ Additional Connecrion ❑Re-Connection ❑ Repairs ❑Disconnect
Job Site/ Owner Information:
Site Address: ` D � C- C�'
Owner: ��� Mailing Address:
City: Zip:
Hoine Phone: Altemate Phone:
Contractor Information:
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Contractor:��v�L �7 � w Contact Person: � �
Address: � �5 /U����� State License #: �� �Z
City: 4�����—(' Zip:S�C�xpira+.;o„ Date: I v� .� � � �
Phone: 7�� `�� � � �l� Alternate Phone: (� � � ��� �� `7 �
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''�` DETERMINING PERMIT:FEES : -
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pernut 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 Q j�(�chd 40 air tested; cast iron
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�V4'ater Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size�_inches;material Schd 40 air tested; copper
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l. SUBTOTAL of Peniut Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) �
ADDITIONAL INFORMATION-WATER iv1"ETERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut.
■ VVATER 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 Pennit; agrees to do
al] work in sn-ict 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,true and con�ect.
.
Applicant: Date: _9 f� 0 ��
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�Y�� �,pATE TIME �
CITY OF ORONO CALLED IN � - � ,�J�J
INSPECTION N IC /� SCHEDULED �"'/
PERMIT NO. ���(d COMPLETED `� y
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ADDRESS '7� _ ����f�9�-��-�e-�/" ,I�.
OWNER CONTR. <T-/''G�� S� �
TELEPHONE N0. ��� �I� �c�'�� - �� 'I�
� DESCRIPTION Y`���f`-' � �K�w��
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION �G26-W69�EPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER 06 PROGRESS
� 07 DEMO-SITE SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP �
T09 PLUMBING Fil 23 SEPTIC FINAL 35 HARD COV�R REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO �
� COMMENTS: �
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GW P(WORK SATISFAC RY:PROCEE Jd"PROJECT COMPLETE
� ❑CORRECT WORK& ROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CA FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (952� 249-4600
OwnerlContrac n site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice