HomeMy WebLinkAbout1996-008435 - water connect ,
� PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 '-���.t�.?�:.�i t� �►��I��;
Crystal Bay, Minnesota 55323 PermitNumber: ti;+:;;V;�:_;�
(612)473-7357 Date Issued: � i-���-,-,:;,��:,
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT%PERMITEE SIGNATURE ISSUED BY SIGNATURE , �'
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' CITY OI' ORONO APPLICATION FOR UTILITY PERNIITS
Box GG (2750 Kelley Parkway) S�W�R/WATER ` �/
Crystal B�y, MN 55323 � ��,
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GGNf:RAL 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 tt�e same day tlle 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 witl�out express approval of the Public Works
Department. [ssuance 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.
JOBSITEADDRESS: �C��`� �v9 �`C� �t�i�.%T� {��
Occupancy Type: )C Residential Commercial
Owner's Name: I�vE_ ��,�,rK�= Plione Number: '�71 - (`��7�_�
Mailing Address: �(o�5�-I <R �� ����v-r- r-�'�>. City: %Yz:��� t'-a �p: `�`� 3��i I
Contractor's Name: � ��_ ���,��-5- (�, :�_,��� Phone Number: `;�1 -;��1 I
MailiugAddeess: �{�U'�/.ciE57Z3ti <<c,�- City: l�L.`�/11u�fTi-F� 7�p: �5S,3�1
PERMIT TYP�
Municipal Sewer Connectio�i ($35.00 per stub) $
pipe size inches; material PVC (on sand fill); cast iron
SAC Charge($850.00)must accompany all sewer pennit applications unless prepaid. If not prepaid,
a sewer connection permit will not be issued.
Muliicipal Water Connection ($35.00 per shib) $ �� ��J
pipe size_� inches; material �< copper; odier
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $139.00; 3/4" meters = $191.00; 1" meters = $247.00)
Separate Plumbing Permit issued for water meter.
Watcr mctcrs niust be sct and sealed by Orono Watcr Dep�rtment(473-7357)upon completion
of mctcr installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIR�D setback from sewer line =20'
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P�RMIT FI:I�: 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. 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 certif es that all statements made on this application are complete, true and correct.
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Signature of Applicant: �� '�1.�0 �� � � '�'``" � � Date: �� ��'- 9��
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE,.-, , , , scHE�u�Eo ' � /
PERMIT N0. ' " '� COMPLETED lT_ �
ADDRESS--(r`�t �:/ !'�4 � ,� L-1 /. :�
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OWNER . . ,� - , �
TELEPHONE NO. `` �� ' ''��`` "> > ��< <� .�c;
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� DESCRIPTION
� 01 FOOTINd 11 MECHANICAL RI 18 D(CAV/GRADINO/FIWNd
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORENVETLANDS
q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP � 17 SITE INSPECTION
� 05 FINAL 14 SEWER H�OK-UO 06 PROGRESS
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~ 07 DEMQ—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
� 10 PIUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �ORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR
G CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
OwnerlCont on s�
Inspector.
White Copyllnspeetor's File Canary CopylSite Notice