HomeMy WebLinkAbout2007-P11025 - sewer connect , PERMIT
CITY GF ORONO
2750 Kel�ley Parkway- PO Box 66 Permit Number: p11025
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
5/22/2007
SITE ADDRESS: 800 Brown Rd N Unit#
Long Lake,MN 55356
PID: 34-118-23-11-0007
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
SAC Fee: $ 1,675.00
TOTAL FEE: $ 1,710.50
APPLICANT: Groth Sewer&Water OWNER: Meg&Jon Pendleton
775 Tower Drive 800 Brown Rd N
Hamel,MN 55340 Long Lake,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.
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PLI T PERMITEE SIGNATURE ISSUED BY SIGNATURE
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Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
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� City Of Ot'OI10 Date Rcceived: Permit#
��� `` P.O.Bos 66
� �� �'� 27�0 Kelley Plrkway � p
❑In-Elouse SAC Determintltion Fo i Com fetcd
�,.� '��� ��� Crystal a�y,MN��323
�a���;,�,�o��o`;� (9�2)2�t9-d600 Approved By(If Required): � " � �2
CITY OF ORONO—SGWER & WATEK/ GEN�I2AL PERMIT
(*Notc:Soinc pcnnits may requirc approval by dic Buildin�Official and/or Public�h�orks Departmcnt*)
(ALL PI:R��ITS- �ia��bc subicct tu furthcr rc��icw and mav not bc issucd whcn thc applicafion is reccived)
GEN�RAL 1NFORMA'I,ION
1. You inay apply for utility pe�rmits by mail or in person at the City offices.
� ?. Mailed in applicatioi�s are subject Co the postage and 1landling fee sho�-vn below. Permit�cards will
be sent by return mail �vithin 2 business days.
� 3. Permits arc not valid unfil�rou receive a permit c�rd.
�l. Worlc must not be��in unless the permit card is available on ihe job site.
5. Utility connection permits may be issued to licensed contractors only.
� 6. Contact the P�iblic Works Department(95?-249-4600)for utility stub as-built locations.
DO NO"C F.�CAVA"CE IN Ah'1'STRGET F1ND DO NOT TAP AN1' iVIt11N H�ithout express
�pproval of the Public Worl:s Department Issuance of a permit does not grant this approval.
7. All work must bc done in accordance���ith State Code rec�uirements.
8. All worl:must be ins�ecCed before it is coveced. Call (952)2�19-4600,24+hour notice required.
TYPC OF PERNIIT
� (Checl< All That A ply)
�Residential (May Require Approval) � Commercial (Approvai Reqtiired)
�New Connection �' Additional Connection �Re-Connection �❑J Repairs � Disconnect
Job Site /Owner Information:
Sitc Address: �bb �1�6V1,� 1�1 -KC�� NG rf(/1
Uwiler: �"eYIC� I� IVlaiii�l� Ac1c(ress: -`�-�'�'l e
c�ty: ��'a�� z��: 5535�
I-(ome 1'hone: _C]�j �"7���C� Alternate f'hone: � �O�Z �J'T—�"���
�
Contractor Information: � ��Z� �3�0- �Z S7
Contractor: �'�U��'1 ��( �'v�.Q✓ Contact Person: I�VV�-f �►�U�
�
Address: � �eJ �(�7�e 1� �1�' State L icense #:
City: _��iirl'�i "Lip:�'J�vExpii•ation Date:
Pllone: ���3 ¢7�"���Z Alternate P11one:
' - DET�RMIIvrING PERMIT FEES
�SAC Chargc(2007 Rate=S1,675.00) �
` (SAC Charge il�ust accompany all sewer permit applicatio�is ut�less prepaid)
(Orono Cit}� Staff can detcrmine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�Sewer Connection/Disconnect/Repair($35.00/Per Stub) �
Pipe size �;��inches; nlaterial �J(i Schd 40 air tested; �_cast iroi�
�� �'4�ater Connection/Disconnect/12epair($35.00/Per Stub) �
Pipe size _inches; material_ __Schd 40 air tested; 0 cop��er
1. SUI3TOTAL of Permit Requested: $
?. STATG SURCI-I,ARGF S .50
3. POSTAGE&i-1r1NDLiNG (Oniy on ivtail-[n Applicltioils) $ 1.50 _
=4. TOTAL P[;atMl'1'F+'E�(Add Lines l-� Above) �
ADD[TION.AL INFORMATION -WATER METERS
m �1'ATER�'IE7'ERS must be picked up and paid for at Orono City Hafl,these are on a separate pern;it.
■ !S'.4'!'�R NIETEI25 musf be set and sealed by Orono �Vater UeparMient (9�2) 249-4G00, upon
completion of inetcr install:ition.
The undersigned hcreby applies to the City of Orono for issuance of a Utility Permit, agrces to do
all w�orl: in strict accordance with the ordinances of the City and the regulations of the Siate of
Minnesota, and certifies tha�ll st ments made on this application are, true and correct.
�
Appliclnt: � Date: �
Reset Form '
SEPTIC SYSTEM INVENTOR Y
Address: 800 Brown Rd N. PID: 3411823110005
Building Typeresidence BRs Install'd for: 4 In Musa: Yes
Permit#: 5235 Date of Permit: 6/29/78 Installer: Widmer
System Type: standard trench Experimental: no Tank Filter:
SYSTEM CONDITION
Conformity: 3 Tank Condition: 5 DF condition: 8 Failure Pot: medium �
p�r �
SEPTIC TANKS �r` ,
Material: concrete block Capacity: 1000, 750
Setback to Bldg: Cesspool: no � �'��
�
DRAINFIELD
Length of Lines: 425 # Lines: 6 Trench Width: 3
Treatment Area: 1275 Type of Filter: Soil Boring: yes
Tile Size: Under Tile: 12 Perc Rate:
Setback DF-Bldg: DF Ht above Wt: 0.8
Soil Type: sandy clay Limitations: water table
WELL DATA
Setbacks - Well-Tanks: 75 Well-DF: 75 Report in File yes
Pump Type: subm. Depth: 120 Diameter: 4 Method: drilled
INSPECTION RECORD PUMPOUT RECORD
DATE DESCRIPTION COMPLIANCE DATE GALLONS
7/19/78 added DF-need risers 1 10/30/86 800
7/16/81 no surfacing-need risers 1 8/1/87 1800
8/5/86 no surfacing-need risers 1 5/1/91
6/29/88 no surfacing 1 1500
10/OS/90 no surfacing-pump tanks 1 8/11/93 1500
5/27/92 no surfacing 1 1/4/96 1500
9/6/95 non-conforming-repair by 12/31/95 3 11/3/98 1800
8/26/98 non-compliant-replace by 12/31/2002 3 t b-� q-� � QO`j
7/20/00 non-compliant-replace by 12/31/2007 3
6/13/02 non-compliant-replace by 12/31/2007 3
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DATE TIME
CITY OF ORONO CALLED IN S'3U `���
INSPECTION NOTI E SCHEDULED S`3/ �% �
PERMIT NO. P j� ��'� COMPLETED
ADDRESS �� �� l�L°'�'� /�c� N
OWNER�.�'�'1.�� CONTR. .��
TELEPHONE NO. �O/ �— �.S` — � ����
� �r 3 y..i�
� DESCRIPTION�� ��
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK- 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ C�RRECT WORK,CALL FOR RE�NSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContractor on site:
Inspector. �� �i /-��S
White Copyllnspector's File Canary CopylSite Notice