HomeMy WebLinkAbout2006-P10519 - sewer connection PERMIT
CITY OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P1o519
C 'rystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 10/31/2006
SITE ADDRESS: 920 Brown Rd S Unit#
Wayzata,MN 55391
PID: 10-117-23-12-0002
DESCRIPTION:
Proposed Use: Residential
Permit Ciass: General
Permit Type:
Sewer and Water Pernut Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: E. 7. Mayers, Inc. OWNER: Jay Hulbert
21300 Larkin Road 920 Brown Rd S
Corcaran,MN 55340 Wayzata,MN 55391
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 ORD[NANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGN TURE [ SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessi�g,(If Septic, 1-Septic) Page 1
� FOR CITY USE ONLY
��� Clty Of Oi'on0 Date Received: Permit#
P.O.Box 66
��y � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
a '�)����L � Crystal Bay,MN 55323
�et�'��h�ijl��o~ (952)249-4600 Approved By(1f Required):
'�Eexa�
CITY OF ORONO — S�WER & WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Ofticial and/or Public Works Department*)
(ALL PERMITS- Niav be subiect to further review and mav not be issued when thc apnlication is received)
GENERAL INFORMATION
1. You may apply for utility pennits by mail or in person at the City offices.
2. Mailed in appiicarions are subject to the postage and handling fee shown below. Pernut cards will
be sent by rehirn mail witl�in 2 busuless days.
3. Permits are not valid until you receive a pernut card.
4. Work must not begin unless the pemut card is available on the job site.
5. Utility coimection pernuts may be issued to liceused conhactors only.
6. Contact the Public Works Department(952-249-4600) for utility shib as-built locarions.
DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN�i�ithout express
approval of the Public Works Department. Issuance of a pemut does not grant this approval.
7. All work must be done in accordance with State Code requirements.
S. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required.
TYPE OE PERMIT
(Check All That ApP1Y)
❑ Residential(May Require Approval) ❑ Commercial(Approval Required)
[�I�Tew Connection ❑Additional Comlection ❑Re-Connection ❑Repairs ❑Disconnect
Job Site/ Owner Information:
Site Address: l� � r'�� �v ��l �d
Owner:�'l ' . iA)0'C�, [�U i t�cv'S Mailing Address: �`�� ���. 'i n.�. �'_
City: � r�fla `1'0�1�� Zi�: �J�_���
Home Phone: �J�v�•' 7 � � "��� Altemate Phone: ���'���' � �rv�
Contractor Information:
f� --1- 1 �/�' C,
Contractor: ,�J , � I �y�-.Contact Person: C_...6�r��� 6�1 cJ�'S
Address: � �6L` �� �i1�� State License #: �-� r�c�'
City: �.✓jm -�2 � Zip:�-��Expiration Date: �� —� 1 �����
Phone: (�l� ��!� �G�� Alternate Phoile: ��� J^ � �O ��O ��
.
DETERMINING PERMIT FEES . � ` `'
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pei�iut applications unless prepaid)
(Orouo City Staff can determuie 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 Schd 40 air tested; cast iron
❑ '�'Vater Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches; material Schd 40 air tested; copper
1. SUBTOTAL of Peniut 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 iVIETERS-
■ WATER METERS must be picked up and paid for at Orono City Hall, these are on a separate pernut.
■ 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 snict accordance with the ordinances of the City and the zegulations of the State of
Minnesota, and certifies that all statements made on this application are,true and conect.
Applicant: Date: � � � � � — ��c,
( /� p-� TIME
� CITY OF ORONO CALLED IN
INSPECTION OTICE C� SCHEDULED I/-Ir�-<)/� �.3 O �
PERMITNO. ��L� � / COMPLETED
ADDRESS C���% ���r�?�'`� � S _
OWNER CONTR. ��.7� .'U��.. i'S
TELEPHONENO. L<` �� ��C D%/_��
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAD\ING/FILUNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/1NETLANDS
ti
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL'�
Z 04 WALL BD. 12 WATER - 17 SITE INSPECTION
Q O5 FINAL � EWER tiQOK:UP 06 PROGRESS
� 07 DEMO-SITE 27�I�IAT 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
� COMMENTS:
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� J��VORK SATISFACTORY:PROCEED �PROJECT COMPLETE
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W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑Cl7RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWfTHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on ite:
Inspector. -
White Copyllnspector' File Canary CopylSite Notice