HomeMy WebLinkAbout2000-P03323 - sewer connection ' �" PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3323
Crystal Bay, Minnesota 55323 Permlt Type: Sewer and Water Permit
(612) 249-4600 Date Issued: >>�29�20
SITE ADDRESS: 80o Brown Rd S
WAYZATA,MN 55391
P I D: 03-117-23-43-0005
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
D ETA I LS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: su[.LivaN'S UTILITY SERVICES OWNER: R A VICKERMAN ET AL W/L EST
3660 HWY 101 S 800 BROWN RD S
WAYZATA, MN 55391 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPEC[FIED
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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APPLICANT PERMITEE SIGNATURE ISSLTED BY SIGNATURE
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Copies: City,Applicant,Assessor,Finance Page 1
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Bos 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 5�323
GEIYERAL INFORMATION
1. You may apply for utility permits by mail or in person at the City offices.
2. Nlailed in applications are subject to the posta�e and handlin�fees shown below. Permit cards will be sent
by return mail the same day the application is received.
;. Permits are not valid until you receive a permit card.
4. Work must not be�in unless the permit card is available on the job site.
�. 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 F
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. Ca11249-4600.
24 hour notice required.
JOB SITE ADDRESS: �a4 S l�J��..�� ���
Occupancy Type: �/ Residential Commercial
Owner's Name: � c r Phone Number: �/7 3 - 7 0� �L
�Iailing Address: � . ����,.�,� ��( City: � R�,u� Zip: s 5 3� I
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Contractor's Name:S�,�,,� N` 5 Phone Number: y73-y.3v�
Nlailing Address: �,�,�, �. �-/,,,.,y �U�' City: ',,�. �, _ 7ip: SS �9!
PERNIIT TYPE
�Iunicipal 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.
`lunicipal `Vater Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER NIETERS must be picked up and paid for at City Hall.
«'ater meters must be set and sealed by Orono`Vater Department(249-4600)upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks= 75'
REQUIRED setback from sewer line =20'
PERtvIIT FEE CALCULATION -���- � ,�
1. Subtotal of above permit requested $ � -
2. State Surchar�e $ .50
The State Building 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) $ '-S 5
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all �vork in strict accordance with the ordinances of the City and the regulations of the State of
`linnesota, and certifies that all statements made on this application are complete,true and correct.
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Signature of Applicant: Date: //'2 `!-�
j DATE � T
CITY OF ORONO CALLED IN /—� �
INSPECTION NOTICE SCHEDULED —��� �' 3�
PERMIT NO. ��-3 COMPLETED �'��
ADDRESS ��"%�O ��'6�'t'� �CI �
OWNER V ��Y��'��"1 CONTR. C-���� V��
TELEPHONE N0. ��3"��3Q�
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 4 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d �IORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
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� LJ1CORRECT WORK&PROCEED f� ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
Cl INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlCont or on site:
Inspector�//�� /
White Copyllnspector's File Canary CopylSite Notice