HomeMy WebLinkAbout2000-P03222 - sewer connection SAC Only � � PERMIT
CITY OF ORO�'�O
2750 Kelley Parkway - Pc� Box 66 Permit Number: Po3222
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(612) 249-4600 Date Issued: 11�3i2oo
SIT�E ADDRESS: 2ti5 Brown Rd S
L+�JNG LAKE, MN 55356
P I D: 03-117-23-24-0009
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit T e: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
YP SAC Only
DETAILS:
Approved per resolution#:
Separate pennits required:
NOTICES/REMARKS:
FEE SUIIIIMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
SAC Fee: $ 1,100.00
TOTAL FEE: $ 1,135.50
APPLICANT: �TTER EXCAVA'I'ING OWNER: A&P KEARNEY III ET AL
7120 VERNON STREET 265 BROWN RD S
ROCKFORD,MN 55373 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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APPL ANT'PERMI7'EE 1 NA URE ' �S D BY SIGNATi.JRE
Copies: City,Applicant,Assessor, Finance Page 1
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� CITY OF ORONO APPLICATION FOR UTILITY PERMITS �
Box 66 (2750 Kelley Parkway) SEWER/WATER ���j-S- �
Crystal Bay, MN 5�323 � .y, �,�
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GEIVERAL 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 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(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 work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 249-4600.
24 hour notice required.
JOB SITE ADDRESS: f -�' s' S ��2` ���'��
Occupancy Type: Residential Commercial
Owner's Name: ,: .-��n- `��--�yt Phone Number:
�Iailing Address: �� � �ti-z �-�— City: 7ip: ��Q
Contractor's Name: ����yu '��-� i^� ��Phone Number:�/�' y /� �/�¢�e % (9r'�
Nlailing Address:�/ ,7 c� 1/�-�-.�a` City: '>�-� ,i-��� 7ip: ��" J
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PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($3�.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
`Vater meters must be set and sealed by Orono Water Department(249-4600)upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Buildin�Code Division Surchar�e of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. PostaQe & 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.
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Signature of Applicant: ������ -���-- Date:
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED �I-3-�`�' � ��(�
PERMITNO. �d j�-�� connP�ETEo �1-3'�°-U � � �'�5
ADDRESS oZ�S 8e��N �� s��i.c��
OWNER Advi av� I�fa✓�1�'� CONTR. K���,�C C—X �-�
TELEPHONE NO.
� DESCRIPTION 5��'`�� ��''"� ���'��
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l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORENVETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER H - P 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 S I AIN . 21 COMPLAINT
J 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� Cl WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED ` ISSUE CERTIFICATE OF OCCUPANCY
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� �i CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call fo he next i s ection 24 hours in advance. 249-460�
OwnerlCont c on si
Inspector.
White Copylinspector's File Canary CopylSife Notice