HomeMy WebLinkAbout1999-011582 - sewer/water disconnect � PERMIT
� ` CITY OF ORONO PERMIT TYPE:
` 2750 Kelley Parkway- P.O. Box 66 -_ �� ��� ��:f��� �€=�
Crystal Bay, Minnesota 55323 Permit Number: _
Date Issued:
(612) 473-7357 .. . . __ . _ =
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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PPUCANT�PERMITEE SIGNATURE . ISSUED BY:SIGNATURE �..
CITY OF ORONO APPLICATION FOR UTILIT�' PER1dIITS
' Box 66 (2750 Kelley Parkway) SEWER/WATER . t,� �> �,.
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• Crystal Bay, MN 55323 ;,.;� ;' / -
GENERAL INFORMATION
1. You may apply for utility permits by mail or in person at the City offices.
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 Departrnent(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 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. Ca11249-4600. .
24 hour notice required.
JOB SITE ADDRESS: (�i� � ��SG�% -� C= �
Occupancy Type: Residential Commercial
Owner's Name: Phone Number:
Mailing Address: City: 7ap:
Contractor's Name: ��� v� a S ..,� Phone Number: � 7�-`�5�
Mailing Address: k,Sot C�. ,/� �s City: ��u� 7ap: S'� �
PERMIT TYPE
Municipal Sewer C� ($35.00 per stub) l�.S��t^zel` $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge ($1,050.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal W ater� ($3 5.00 per stub) �,`5��,n n,�c f' $ r
pipe size inches; material copper; other •
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $130.00; 3/4" meters= $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(249-4600) 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 Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage & Handling (Only mail-in applications) $ 1.50
4. TOTAL PERNIIT FEE (add lines 1-3 above) $ g
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 on this application are complete, true and correct.
Signature of Applicant: Date: ���'�S
ATE TIME
CITY OF ORONO CALLED IN •` �/� �--
INSPECTION NOTICE SCHEDULED fo%c'4�1�5 ��
PERMIT NO. �/-� �=L COMPLETED
ADDRESS��o �'3 ��c_..c� `..�'� -
OWNER CONTR. ��-��-�
TELEPHONE NO. � 7..? _ �.C� .���
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� DESCRIPTION .� r- o,�`
�
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICA�FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. - 17 SITE INSPECTION
Q 05 FINAL 14 WER H O6 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 ORK SATISFACTORY:PROCEED C� PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �_ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
=l' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47 -73rJ7
Owner/Contr on site:
Inspector. '�
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