HomeMy WebLinkAbout2007-P10966 (sewer & water) � . . �
PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10966
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 5/4/2007
SITE ADDRESS: 3799 Casco Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-32-0021
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connecrions
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Simon Excavating OWNER: Kenneth Rennick
23118 320th St 32670 195th Avenue
LeCenter,MN 56057 New Prague,MN 56071
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK 1N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
/ �—�
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
. _ , �
P'OR CITY LiSE ONLY
�� Cit Of O►'ono Date Received: Permit#
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,� ��'�;� 27�0 Kelle�Parktica�
, , y y ❑Iu-House SAC Detennination Form Complefed
1� qa,'�_ �.� Cp�stal Bay,MN 5�32�
��\�:,`�,;i,.��;P�c`;i (952)2d9-'Y600 Approved[3y(It'Requircd):
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CITY OF ORONO—S�W�12 & WATER/ GENEI2AL PERMIT
(*Note:Some�ennits may requirc appro��11 by thc[3uilding Ot�ficial and/or Public Works Departincnt*)
(r\LL PGR�'(ITS- i�'iav be subiect lo furfher review o�nd m��y nof be issuccl wlien�I�c.i[�plication is recei��ed)
G�NERAL INI=ORMATION
L You n�ay apply for utility permits by mail or in person at the City offices.
2. Mailed in applications are su�ject to the postage and handling fee sho���n belo��,�. Permit ca�-ds will
bc sent b�� return mail �vithin 2 busincss days.
3. Permits arc not valid uutil you receive a permit card.
�. Worl:must not begin unless the permit card is available on the,job siYe.
5. Utility connection permits may be issued to licensed contractors only.
� 6. Contact the Public Worl:s Dc-plrtment(952-249-4600)for utility stub as-built Ic�catioi�s.
DO NOT��CAVATE IN ANl'STRGET AND DO NOT TAP ANl'NIAIN without cxpress
app�roval of the Public 1Yorl:s Dep.u•t►nent. Issuance of a permit does not grant this approval.
7. All worl:musc be donc in accordance�vith State C.ode requirements.
3. r111 �vorl. must be inspected bcfore it is covercd. Call(9�2)?49-�1600,24+hour notice requirecf.
� TYPC OF PERNIIT
(Checl<All That A 1 ) �
� Residential (t��tay IZeql�ire Approval) � Commercial (Approval Required)
� Ne��r Connection I� Additional Connection � Re-Connection �[]] Repairs � Disconnect
Job Site/ Owner Information:
Site Addcess: ���� �.rGo ,��
G�vner:, �� i/f�i����� ivlai liny Acidress: �z�7� �9����vG
City: �� /�-��.T/�/� 7ip: �/�c?/
Home PlZone: �'SZ•Z�Z -31�� Alternate 1'hone: `---'�'�
COtll['3C101' Illf01'lllal1011: I
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Contractor: ..,,�.s, ��,-���� Contact Person:
��,� � ���
Address: Z�j/� �Zc ��J��� State License #: /���
City: l�c��r�— 1 ip:���piration Date: �G�'p
P11onc: �,���,� —����Alterllate Pllone:
� • - .
DETERMINING PERMIT FEES
[� SAC Chargc(2007 Rate=�1,675.00) $
(SAC Chargc must accompany all sewer permit applications unless prepaid)
(Orotlo City Staff can determine if applicable)
(If not prepaid,� sewer connection permit will not be issued)
�„Se er Connection/ isconnect/12epair(�35.00/Per Shib) �
P ' ches; material__Schd 40 air tested; 0 cast iron
��Va -r Connection Disconnect/Rep�ir(�35.00/I'er Stub) �
Pi} size �nches; material_ _Schd 40 air tested; � copper
l. SUBTOTAL of Permit Requested: $
2. STATG SURCI-IARGE $ .50
3. POS"C�1GE& HAIvDLING(Oniy on ylail-In Appiications) S 1.50
4. TOTAL 3'E➢ZNII"II'FEE (Add Lines 1-, r�bove) n
ADD[TIONAL INFORMATION -VVATER ME"I'ERS
� ��'A"CER�IETEKS must be picked up and paid for at Orono City Hall,these are on a seoarate permit.
� l�VA"I'l�.I2 N�L7'EAS m��st be set �nd se�►led by Orono �Vate�• Dep��•tment (9�2) 249-4G00, u�on
completion of ineter installation.
The undersigned hcrcbv applies to the City of Orono for issuance of a Utility Permit, agrees to do
all ��ork in strict accordance with thc ordinances of the City and tlle regulations of the State of
Minnesota, anci certifies that all statements made on this application are, true and correct.
�� �
Applicant: �` Date: � � p'
Reset Form
(J—� AT TIME "
CITY OF ORONO CALLED I �/ ��
INSPECTION N ICE / SCHEDUL�tS �s�5� �� �
PERMIT NO. �� (O COMPLETED
ADDRESS t3��_CI �L�eS�'.D i'��(!/�
OWNER -� CONTR. �
TELEPHONE NO. QSZ Z'�z Z�� ✓l�'kOK�-
� DESCRIPTION` 'Z��SE� ��1�-+t.�.C'�07�t
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ext inspection 24 hours in advance. (952� 249-460�
Owner/Cont site:
Inspector.
White Copyllnspector's ile Canary Copy/Site Notice