HomeMy WebLinkAbout2004-P07583 (sewer & water repair) CITY OF ORONO PERMIT
2750�Kelley Parkway - PO Box 66 Permit Number: Po�sg3
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 6i9i2ooa
SITE ADDRESS: 3287 Casco Cir
Wayzata,MN 55391
PI D: 20-117-23-43-0044
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DESCRI PTION: �\
Proposed Use: Residential
Permit Class: General
Perniit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Repair
DETAILS:
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: Coppin Sewer&Water OWNER: Jon&Kathleen Wright
5089 Shoreline Drive 3287 Casco Cir
Mound,MN 55364 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 ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANTPERMITE GNATURE 1 SUEDBYSIGNATURE
Copies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(Lpdated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Ba�•;MN 55323
GENERAL I\�'ORI�IATION
1. You may apply for utility pemuts 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 the same day
the applicarion is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts 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 L\:�NY STREET AND
DO I`OT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a permit does not grant this approval.
7. All�ti�ork must be done in accordance with State Code requirements.
8. All��ork must be inspected before it is covered. Call(952)249-4600,24 hour notice required.
JOB SITE ADDRESS: 3� �� C�c�s �� C-'� r
Occupancy Type: �' Residential Commercial
Owner's Name: \<a �„y �.ti�r`� u L„� Phone Number:`t � 3 C� � � �
Mailing Address: City: Zip:
Contractor's Name: C_-e �'Q �,:�; S a-� Phone Number: `I � �4 �� � 3 b
Mailing Address:S� ��'IS1,�� �'c \� .� � r City: ��7��c,, h J Zip:SS 3�-�
PERMIT TYPE ❑Connections epairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size�inches; material 4'V�Schd 40 air tested; cast iron
� Municipal �Vater Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
; (952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line =20'
R PERMIT FEE CALCULATION
` 1. Subtotal of above permit requested $
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pemut must be
included for each well,sewer and water connection pernut requested.
� 3. PostaQe & Handlina (Only mail-in applications) $ 1.50 (Mail In Only)
:. 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 v��ork in strict
� accordance�ti�ith the ordinan �s of the City and the regulations of the State of Minnesota, and certifies that all statements
made on this application a omplete, true an correct.
' Signature of Applic � � Date: � � � � �
5�� /� �
DATE TIME
CITY OF ORONO CALLED IN '7 IO ��
INSPECTION NOTICE SCHEDULED � o
PERMIT NO. p�� ��$ `3 COMPLETED
ADDRESS �Z-� � CG�S�O C� •
OWNER CONTR.�,,��;� So � � ��
TELEPHONE NO. �'C� � ���� � ��!/ � ��'--�
� DESCRIPTION �-F-�- ��_��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAI. 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED n ISSUE CERTIFICATE OF OCCUPANCY
Q ❑COFiRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �J pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR !� CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (Q52� 249-46�0
OwnerlContra ite:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice