HomeMy WebLinkAbout1994-006212 (sewer & water) PER�_tt��T
CITY OF ORONO PERMIT TYPE: --�---�� � -� ��� � � `�`�
2750 Kelley Parkway • P.O. Box 815 :_'`f��'=`-`...
Orono, Minnesota 55356-0815 Permit Number: ;,;:,, ;_,,_;.;,_,F
(6+�2) 473-7357 Date Issued:
SITE ADDRESS: -�=;c_;�_� �=:�a°�:�;::�:: i���,:�,•:�� ��-,
DESCRIPTION: ,.;{,_�..;_:�;' ;:�;.��,s;.���::��:�_.ts
l'N 7.h.�(' "=I�, �:C�E_ �1'•���,. .�� ._ ...f'�
— � y. iRi_ ��� �: � � #;:";'��+ {`•�� E'i�`�'
_ 1 r_ _. . ;'t _ ,i i _ 1 , .s,•, : _. . _ t�_::
— s ,,�.—.
_:tj�}t�.,t`• _. uf��i'�.=.. . ��.�i�k:; ��fC::S.'= -:i�:_ { i,iFt�ft_.�
Lt/_!, L!r I.:1SVl��L'
t t Ai:'A3f�L t!i»Ti'�
e �.zxnlr�•� vi ! 1��
�3 _' "Ie'ii}i!r} fi�'
A d 1�J�.t 4�VVV L� �I
V.L LLIi J�:��tVS
Y:"':".'f}lifilZil t4
1G.i�iiVVVLV 17
f!T !L A1 �!I
V1 LLIt •rfV
REMARKS:
FEE SUMMARY:
_;:i:'�... . ...... . _. .. . _��.�
_.•:1_._r.^ {.i��' "
j '�.iry_ �.i 3 . r P�,r �__..�.��'�._�,,�.�5�._1�7
•'1._ � -
CV���T1����: �� . _ _ ^._�I`�:'•�i� � '�_ ���i���. . �'i.�y
. .G.•_'t 'vi 1••.��!
�;;�; _ i_;E f�' _ _ —— - � r_:(�'_�i�!_; j='E i i r���T i;'[j
_ .._._ . ._� �°jr� �,.E,.'�.._. �_`-,_Lu; i s`�(�,� _. _. _:��.
l:+=��'-. , ',-�i=.—=�� i ii r':_�li_. :;, 1.—� ._ =;`�i
_,. ;:_. . _ _�.,r. -
+ � �#�.t�{f. �'.-� � �� �-r.�',:� ?' .' .�. , °� .. . .. � . f'i i '.- ��T I-fiit !f_E �''',i''i�.i . '"._. . ._.. .._ �.i'.�" ?`._tt.'_. ._.. . . _.
. . _. _._ F€ t .�� —
,_ ,.,._.„ „ _ `
,._ ! } ,_� , ; i 2 �_ _ . ! .; ; i�'3i, f\; : f;�i�'S � _ `i',_e S' :'{;_
�, ...__ _.: ._>_:.� : 1 �.:
:::• , :�
� .-.r
i • � �•`•' � +
�... ._.
. � .... : . ..,. _._ . . . � ;��, . _ .. _ . . . _.�. _ _ . . _
;:
.. . _ . __ ._ .. .... . _.. . .� ._ _ . . __ '3. �._ _ r �
i��c�at.{� ' � � �- . •*� .._.,. , - — -
_! { �.'_.4 ' L. . !—:y:, y ! �...� }� t. .., i . ;.�- L.s t r t..
� � ;
• ". z i �
:.
_...
.. . .... . . .., . .. ._ . . _ . . .... .... . ' - � .: �..
._._. _ . ... _. _ ..._.S_ I.. ..... ..,.� . ..?
L �
� ��'�-Z> �/��/-'1���
�
APPLICANT-PERMITEE SIGNATURE - ISSUED BY SIGNATURE
c;rr Y u��� uuu�v u !�r��.i�A�r�uiv r u� u�ri�,ri�Y r�:xlvirr5 �.
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
s
` GEN�RAL INFORMATION
1. You may apply for utility permits by mail or in person at the City offices.
r 2. Mailed in applications are subject to the postage and handling fees shown below. Permit cards will be sent
by return mail the same day the application is received.
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(473-7357)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
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 473-7357. �'
24 hour notice required.
�/ ,,� ��
JOB SITE ADDRESS: � �j Ci U� (�--c��._�-�-- ,/ ��` /�-�2-
Occupancy Type: . ` Residential Commercial l.�7/ - �� ��
Owner's Name: '-,��-z6-n-�- %��-c��-�-- PhoneNumber: �_j �f— /�{ 7�'
Mailing Address: 2 �;p a z-�-- .-� r,�C City: �,�-z � 7ip:
Contractor's Name: �,, �-L-E-h /�-���- �oneNumber: " � - '/_�' v
Mailing Address: City: , 7ip: �j 5' �Z �7'
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size � inches; material PVC (on sand fill); cast iron
SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size � inches; material � copper; other
WATER �}�s�ed up and paid for at City Hall. �/
(5/8" meters = $133.00; � 3/4" meters = $181.00; 1" meters = $235.00) �^ :�-
Separate um ing Permit issued for water meter. "
Water meters must be set and sealed by Orono Water Department (473-7357) upon
completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surchazge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta e & Handlin� (Only mail-in applications) $ 1.50
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 work in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application are complete, true and
correct.
� � _�
Signature of Applicant. �-��-e ��L� � � `�
/�
CITY OF ORONO DATE TIME
CALLED IN ^� -��
INSPECTION NOTICE SCHEDULED � -,z 7' � ; �
PERMIT NO. ��/� COMPLETED
ADDRESS ���� � a.�/(� 4 Li
L�aa-c.�, ,�,� /�d
OWNER CONTR. �_�'.tG�
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI
Q 02 FRAMING 16 WELLTEST PUMP
� 11MECHANICALFINAL 18EXCAWGRADING/FILLING
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
= 04 WqLL BD. WATER HOOK-UP .
� 05 FINAL RN ON 34 TREE REMOVAL
13 ME 17 SITE INSPECTION
{� 07 DEMO-SITE 14 SEWER HOOK-UP
v 07 DEMO-FINAL �PROGRESS
�Q 27 SEPTIC MAINT. 21 COMPLAINT
09 PLUMBING RI 15 SEPTIC INSTALL.
J 10 PLUMBING FINAL z2 FOLLOW-UP
23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
W
�
�
J
O
�.
�
O
�
W
�
Q
�
� }
� Z
�N � J g o o a
� • a j � `�
z � Z
c V � Q o a � " f�
.� U
H
Q ¢ � w cn ~ a W O O � Z � d
� p � acnz > > F w o Q w M o
C " = � Z � g � ° o w � � Z � �o
a w w C7 a O O Z J a d a p 1 z
� c� Ywwo � � c� � a v � w M ::
w � � v~—i a � � _ � O � w a w c=n � in
Q S � � � M r O N N M M � W � Z � O
a
� w � � V i.
`a � v=i � � � c
w a � a U > V
ac � g �u � � : �
� a C
z w � Z � vi �n
p � � c� �
W = g �- U � � Z z > > � Z ° � t
p� �.: -� I U
U tUn � ,•,C�] • U U 00 O O Q � z y Z I W N
�ti. Z Z � 2 2 � ? � � O � C
¢ Z O
2 2 O w w C� U U U Z O � �. y
Q w w 3 a � a a a I n�', � U � y LL
V ' 2 � N � (n to (n ln � o Z 3 � � �G N
�1 � � v � � r� � r� a w � o
,V� � � N N N � � Q ¢ O � ? � � _ �
W �� � W O W O F- f- J a x N
() � d U u. o w a V N c
O O .� Z ¢ U O C � i.
� 0 � � o~c Q a a v� � w � � � o
Z Z Z J � O Y Y� LL � � U' � :%
� Z W � w a ¢ LL a fN LL � � w vai O a � .� � 3
p0 Z z ~ Z � � `� � 30 � � w z �—� c
O (~j H W OC 2 a z z � m cn LL m m � W vai U U w c~i � ¢ � U V O
�} a � � Z J No � � � a � � > > W � � � o ° � Z a � a� �
F�.Z W � 3 W W " " ? � o o a a 3 0 1{� O O w� O � Z O tn
U a Q � H � o 0 0 0 0 0 0 0 � O U �� � � ❑ ❑ ❑ �
i.(13�b30Nb'H17t/3H 7b'NOSN3d�l(]O.t �10�3Xb'S1N3W3�/lna3t1300�