HomeMy WebLinkAbout2004-P08101 - sewer/water permit CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Posio�
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: io�2oi2oo4
SITE ADDRESS: 2618 Casco Point Rd
Wayzata,MN 55391
P I D: 20-117-23-24-003 8
D ESC RI PTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate pemuts required:
NOTICES/REMARKS:
Disconnect sewer and water
FEE SUMMARY: Permit Fee: $ ��•o� Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: �'�'estonka Water&Sewer OWNER: Eric Vogstrom
6501 County 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 SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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A CANT PERMITEE SIGNATURE SSUED BY SIGNATURL
Copies: 1-File(SiQnitures Required), 1-Apvlicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(Updated 1/5/04)
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CITY Q� ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER & SAC
Crystal Bay, MN 55323
GENERAL INFORI'IATION
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 belo�v. Pernut cards will be seut by rehirn 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 peinut card is available on the job site.
5. Utility coiuiection pernuts may Ue issued to licensed conri-actors 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 Depai�inent. Issuance of a pemut does not grant this approval.
7. All�vork must Ue done in accordauce with State Code requirements.
S. All work nlust be inspected before it is covered. Call(952)249-4600,24 hour notice required.
JOB SITE ADDRESS: ,-?�?� � �1<< �C.-v r� ��' `�
Occupancy Type: Residential Commercial
Owner's Name:��,f:3��� u� � ��'� � � Phone Numbe►•:
Mailing Address: City: Zip:
Contractor's Name: �������J�� �S �L� Phone Numbei: �a�_?��� - �ls=��
Nlailing Address: L� -'�'l L�� i.='�� �S City• ,�-:�� 7 Zip; `_>> 36`t
PERMIT TYPE ❑ Coiulections ❑Repairs �sconnect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accompany all sewer pennit applications unless prepaid.
(If not p�-epaid, a sewer connection will not be issued)
Municipal Sewer i��ection/Discan-r�e�IRepair ($35.00 per stub) $
pipe size-��inches; material Schd 40 air tested; 'l cast iron
Municipal W1ter �onnection/�`'1srniu�ect'1Repair ($35.00 per stub) $
pipe size -1 inches; inaterial�opper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orouo Water Department
(952-249-4600) upon completion of ineter installation.
REQUIRED minimwn setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line =20'
PERMIT FEE CALCULATION
1. Subtotal of above pennit requested $
2. State Surcharae $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut inust be
included for each well,sewer and water connection perxnit requested.
3. Postage & Handlin� (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 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. ,,, �
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Signature of Applicant: ._����� Date: � �
� DA TIME V "
CITY OF ORONO - CALLED IN l�"��
INSPECTION TI SCHEDULED /D- -D� a:�90
PERMIT NO. � d � COMPLETED ��'�'
ADDRESS a�D�B �L4 � �
OWNER CONTR.
TELEPHONE NO. 9S2 -�7�"" �S9
� DESCRIPTION c�'�Gt!'�C-� �Gcit.r�. LI.S
lL 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 REMOVAI
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED I ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE r^"�'�ING
PERMANENT
❑COR� �CONDITION WITHIN HOURS. ❑ pHOTOTAKEN
lL RETURN
` CALL INSPECTOR !� CITATION ISSUED
CALL TO ARRANGE ACCESS.
inspection 24 hours in advance. (952� 249-46��
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