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HomeMy WebLinkAbout2005-P08621 - sewer/water permit PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 pos62i Crystal Bay, Minnesota 55323 Permit Type: seWer ana wacer Pe�t (952) 249-4600 Date Issued: 4�i9i2oos SITE ADDRESS: 2618 Casco Point Rd Wayzata,MN 55391 P I D: 20-117-23-24-003 8 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Sub-type(s): Sewer&Water Connections Permit Type: Sewer and Water Permit DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 70.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 70.50 APPLICANT: �'estonka Sewer&Water OWNER; Eric Vogstrom 6501 Co. Rd 15 2618 Casco Point Rd 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 ORD�ANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �„ C� Q � �,�,,-- �k�C APPLICANT PERM[TEE SIGNATURE �`� ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Pog62i Crystal Bay, Minnesota 55323 Permit Type: seWer and wacer Pe�c (952) 249-4600 Date Issued: aii9i2oos SITE ADDRESS: 2618 Casco Point Rd Wayzata,MN 55391 P��: 20-117-23-24-003 8 DESCRIPTION: Proposed Use: Residential , C� Permit Class: General �� ��� � Permit Sub-type(s): Sewer&Water Di nnecri< Pernut Type: Sewer and Water Permit DETAILS: Approved per resolution#: Separate pernuts required: — ��. NOTICES/REMARKS: � �4` �'J _ ���''` FEE SUMMARY: Permit Fee: $ 70.00 � Valuation: $ 0.00 � 1�+ , `�� State Surcharge Fee: $ 0.50 Q� �` k�� �� � TOTAL FEE: $ 70.50 APPLICANT: �'�'estonka Sewer&Water OWNER: Eric Vogstrom 6501 Co.Rd 15 2618 Casco Point Rd Mound,MN 55364 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESI'S 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 REQUI MENTS. � � � �--����riz�-�. ���� AP L[CANT PERM[TEE SIGNATURE -� ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1 f ' e • • FOR CITY USE ONLY �,►` City of Orono Date Received: Permit# � `Y P.O.Box 66 ��„ � 2750 Kelley Parkway ❑In-House SAC Detern�ination Form Completed a j�'����; � Crystal Bay,MN 55323 � ���i�..�o~ (952)249-4600 Approved By(If Required): �'tssao� CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may require approval Uy the Building Official and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issucd when the aoplication is received) GENERAL INFORMATION 1. You may apply for utility pernuts by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Pernut cards will be sent by retuin mail within 2 business days. 3. Permits are not valid until you receive a permit card. 4. Work must not begin unless the pemut 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 ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a peimit does not grant this approval. 7. All work must be done ui 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 Apply) �Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect Job Site/ Owner Information: ��Site Address: �f;� � � c�'S<<-' �a�� `� � Owner: ��� C �,�fJq��a���;�..-• Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: -� l� ' f�� l �C Contractor: � � :� (,� Contact Person: r ��� � �'� Address: �C�� � � � � State License #: "1 ��' �� � � � City: ✓�th.�v l Zip: �5�`�Expiration Date: ��- 3�-41S Phone: �i � ��7�-�{ �' Alternate Phone: ��Z ���(I - `� 7� I � � � r % : � , s , � 3, � `� � �� � "`��' � � _ _ , . '� , � I DETERMINING PERMIT FEES ❑ SAC Charge(2005 Rate=$1,450.00) $ (SAC Charge must accompany all sewer peimit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) Sewer Connec 'on/Disconnect/Repair($35.00/Per Stub) $ �ipe size�inches;material Schd 40 air tested; cast uon � �ater Connection/Disconnect/Repair($35.00/Per Stub $ Pipe size�inches,material�_�sk�-�6 au tested; copper ���� 1. SUBTOTAL of Permit Re uested: � $ 9 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 METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pemut. ■ 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 strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statement made on this application are,true and correct. r Applicant: Date: C � ` I � . � � ` � : � �� � „ ,� � b � ' �.5 � �:I :� '� , � � � H,` ��E� ,� / `j D TE TIME 'V � ��/ -�/�r�_ CITY OF ORONO � CALLED IN r �'��`! -J INSPECTION NOTIC� (�� � SCHEDULED •�1%�5� -^� PERMIT NO.— � �+ D�S' COMPLETED ADDRESS �.(y / � � Ci/� C� u /,�t �� OWNER CONTR. �,s�,(.?1J,���Cr. TELEPHONE NO. j'�� L/ 7 �' - y �� �C� � DESCRIPTION `�� ��h � ��� C' � 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 OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:�YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED L� PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the ne inspection 24 hours in advance. (952� 249-4600 OwnerlContrac n e: Inspector. � - i;�.� White Copyllnspector's File Canary CopylSite Notice