HomeMy WebLinkAbout2006-P10244 - sewer and water disconnect � PERMIT
` C1TY OF ORONO
2�50 Kelley Parkway- PO Box 66 Permit Number: p10244
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued: 8/21/2006
SITE ADDRESS: 2585 Dunwoody Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-21-0032
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Pernut Permit Sub-type(s): Sewer&Water Disconnectic
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Perniit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Widmer Construction LLC OWNER: James&Amy Dailey
9455 County Rd. 15 2585 Dunwoody Ave
Maple Plain,MN 55359 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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APPLICANT PERMITEE SIGNAT RE ISSUED BY SIGNATUR
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR C[TY USE ONLY
4�� City of 01'ono Date Received: Permit#
P.O.Box 66
�� � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
a ���rC � Crystal Bay,MN 55323
�'� ��� ��b o~ (952)249-46�0 Approved By(If Required):
t'�'Ps�fa$ti
CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT
(*Note:Some pem�its may require approval by the Building Ofticial and/or Public Works Department*)
(AI L PERMITS- MaV be sublect to further review and may not be issued when the annlication is received)
GENERAL INFORMATION
L You may apply for utility permits by mail or in person at the City offices.
2. Mailed in applicarions are subject to the postage and handling fee shown bzlow. Pern7it cards will
be sent by rehu�n mail within 2 business days.
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 coiuiection permits may be issued to licensed conh�actors only.
6. Contact the Public Works Department(952-249-4600)for utility shib as-built locations.
DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express
approval of tlie Public VVorks Department. Issuance of a pernut 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 APPIY)
❑Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑Additional Connection ❑Re-Connection ❑ Repairs Disconnect
Job Site/ Owner Information:
Site Address: -� 5 �� r`�•� � Lv c� c�<��1 �V �..
Owner: �� �ri: nC ��c;t� � .'J z'(,l�, Maiiing Address:
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City: Zip:
Home Phone: �"I � I � S� � Altemate Phone:
Contractor Information:
Contractar: rv'J�-:���7�_ C�c1�_ �i� G �"� �,'/��/�G�'.�/'��-
�%id.r/ Contact Person: �y �/�9
Address: ,�y�� �� !�� State License#:
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City: ����0"�'�f'� ZipS,S��-�Expiration Date:
Phone: �� "��-s ���� Alternate Phone: C�`�'��J��d� �
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� DETERMINTNG PERMIT:FEES `
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
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��Sewer Connecti n/Disconnect/Rep ir($35.00/Per Stub) $
Pipe size s•ma � Schd 40 air tested; cast iron
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� VVater Connection/ isconnect/ epair($35.00/Per Stub) $
Pipe size inch • �al Schd 40 air tested; copper
1. SUBTOTAL of Pernut 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 1vIETERS
■ 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 st�ict 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,true and con-ect.
Applicant:�� " " ���``�L Date: �0�/-4�
DAT I M
CITY OF ORONO CALLED IN
INSPECTION T CE SCHEDULED
PERMIT NO. �I O�� COMPLETED
ADDRESS ��)�� 'J�n W UOC.I�.-� ���
OWNER CONTR. �n�
TELEPHONE NO. �I a• a�5 -�� �3
CU�-ed2
� DESCRIPTION �/�f nl�n ����C�p 1'�Q C-� �b l�e
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETIJRN
�STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED
G INSPECTION RE�UtRED.CALLTO ARRANGE ACCESS.
Call for the ext inspection 24 hours in advance. (952� 249-4600
OwnerlContr� n site:
Inspector.
White Copyllnspecto's File Canary CopylSite Notice