HomeMy WebLinkAbout2007-P11719 (sewer connection) �- PERMIT
GITY OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P11719
Crystal Bay, Minnesota 55323 Permit Type: sewer and water Permit
(952) 249-4600 Date Issued:
11/28/2007
SITE ADDRESS: 3249 Casco Cir Unit#
Wayzata,MN 55391
PI D: 20-117-23-43-0008
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:
SAC grandfathered in#1516-06/16/67
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
'rOTAL FEE: $ 35.50
APPLICANT: Stasney Mechanical, Inc. OWNER: Robert Luesse
1574 3rd St. SW 3249 Casco Cir
New Prague,MN 56071 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIF[ED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
LICAN7'PERMITBE SIGNATliRE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�
.
TOR CITY IISE ONL1'
�;�(��`�\ Clty of 01'ono Date Received: Permit#
//� `Y�,, P.O.Box 66
r�' , '� 27501kelle Parkwa �
�� y y ❑In-House SAC Determinat�on Form Completed
i��� i��X•`. �� Crystal Bay,MN 55323
d' �r,�.�G`/ (952)249-4600 Approved By(If Requi�ed)_
\��oa.;
CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department")
(ALL PF,RMITS- Ma��be subiect to further review and mav not be issued when the aoplicAtion is received)
GENERAL INFORMATION
l. 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 fee shown below. Permit cards will
be sent by return mail within 2 business days.
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(952-249-4600)for utility stub as-built locations.
DO NOT EXCAVATE IN ANl'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 (952)249-4600,24+hour notice required.
TYPE OF PERMIT �
(Check All That A 1 )
� Residential(May Require Approval) � Commercial(Approval Required)
� New Connection � Additional Connection �Re-Connection �epairs � Disconnect
Job Site/Owner Informatio►1:
--, ��I ' -, , I
Site Address: -�� 1 � �- a 5�� �_ I y C_ ! �.
Owner: i-- U � 5 j (' Mailing Address:
City: L:i L%�C� Zip:
Home Phone: Alternate Phone:
Contractor Infor�r�ation: �
r y� q
Contractor: �I`151��� I''I{c����"'��NfContact Person: ��Y� � ��W, �' ��
Address: State License#:
City: f�1��� ��P �� Zip: Expiration Date:
,
Phone: �)5�� --] `� ' ��nd Alternate Phone:
�
DETERMINING PERMIT FEES
� SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connectioo permit wi11 not be issued) �
� Sewer Conn ction/Disconnect/Repair($3�.00/Per Stub) $ �� �
Pipe size � inches;material ��{a� Schd 40 air tested; � cast iron
Q Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; 0 copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING (On(y on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
ADDITTONAL INFORMATION-WATER METERS
• WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
compietion of ineter installation.
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 ardinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are,true and correct.
Applicant: ����1�Q ����b`�� Date: �� ����'�� /
Reset Form
(, �`� �//�� TIME "
� ITY OF ORONO CALLED IN ��
// �� �—
INSPECTION NO IC� , scHEou�Eo l �— 7 . ��
PERMIT NO. COMP�E o
ADDRESS � r�-��1�,G�� �(`�
OWNER CONTR.
TELEPHONE NO. �� `��� — �W�I D
� DESCRIPTION 1 � ���'LQ C�\b�\
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEP ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO ME YOU: YES_NO
� COMMENTS:
�
W
�
�
J
O
�, r
�
° � a
w
�
Q
�
z
W
�
W
� ' � �
a
W� CT . OJECTCO LETE
W ❑CORRECT WORK&PROCEED ^; ISSU CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITNIN HOURS. G PHOTO TAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (J52� 249-4600
Owner/Contractor on site:
Inspector. �,/V
White Copyllnspector's File Canary CopylSite Notice