HomeMy WebLinkAbout2002-P05745 - sewer/water permit CITY OF ORONO PERMIT
2750 Kelley Par�;way - PO Box 66 Permit Number: pos�4s
Crystal Bay, Minnesota 55323 Permit Type: seWer and water Pe�t
(952) 249-4600 Date Issued: ioi2zi2oo2
SITE ADDRESS: 2817 Casco Pt Rd
Wayzata,MN 55391
P I D: 20-117-2 3-3 2-0010
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pernut Type: Sewer and Water Pernut Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolurion#:
Separate pemuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Tonka Plumbing OWNER: Wesley&Brenda Bryne
265 Cry Rd 110 North 2817 Casco Pt 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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APPLICANT PERMITEE SIGNATURG SUGD BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessins, 1-Finance Page i
(iTpdated 5/3/02)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL IIV"FORMATION
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. 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.
�. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts 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 Departrnent. Issuance 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(952)249-4600,24 hour notice required. ;
JOB SITE ADDRESS: �'t{'�� CcS�.c., Pf K� r
Occupancy Type: Residential Commercial
Owner's Name: 'W�s � re.,,��., r3 ��� Phone Number:`�5�-� 47% - oG i"�
Mailing Address: �b►� ,co Pf (�J City: �«�.�c� Zip:
Contractor's Name: �on�� �,1� ' Phone Number: �is:3 ��a��raa�
Mailing Address: �.� 5 � �Z�' 0 City: M;�ra ��.<�'� Zip:SS 6�
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PERMIT TYPE �c.;onnections ❑Repairs ❑Disconnect (Check One)
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SAC Charge (2002 rate $1,200.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
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Municipal Sewer Co ection/Disconnect/Repair($35.00 per stub) $ � .-�
pipe size�nches; material Schd 40 air tested; cast iron
Municipal Water Con ection/Disconnect/Repair ($35.00 per stub) $ �� '
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pipe size inches; material copper; other '
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department -
(952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION �] �
1. Subtotal of above permit requested $ l � ' �
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well,sewer and water connection pemut requested.
3. PostaQe & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only)
4. TOTAL PERMIT FEE (add lines 1-3 above) $ �� �-�
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The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work in strict �
accardance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements ;
made on this application are co lete, true and correct.
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Si ature of A licant: ��/��� Date: /�%�.;? /-�``
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