HomeMy WebLinkAbout1991-004096 - sewer & water L y
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1335 Brown Rd. South • P.0 '::_ Permit Number: ;��-?��'.'���<<
Crystal Bay, Minnesota 55323 Date Issued: s.;::'�' ���'}'`=`�
(612) 473-7357
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1f'PIJCANT PERMITEE SIGNATURE ISSUED BY'SIGNATURE � �"� �
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
'Box 66 (1335 So Brown Rd) , ���� SEWER WATER _
Crystal Bay, MN 55323
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I:- You may�'a ply�or utility permits by mail or in perscn at the City offices.
2. Mailed in applications are subject to the postage and handling fees showri below.
Permit cards will be sent by return mail the sam�e day the application is received.
3. Pe.�its are not valid imtil you reoeive a �*�*+�;t 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 Departm�e.nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY SZREET AND DO NOT TAP ANY MAIN without express approval of the
Public Works Depa.rtment. 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 473-7357.
24 ha�ir natioe required.
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JOB SITE ADDRESS: ����� �$�i�✓�,S �'� /�'� ;
Occupancy Type: Residential Commercial
OWNER'S NAME: Phone No. :
Mailing Address : City:
.1 �/ �
CONTRACTOR'S NAME: l.c.�`y-;l tif�K��, �«rz i" ,� C..��� �c"J Bus . Phone: `f %-� - c_ S �
Mailing Address: �->( Cc�, ,��; �L'- City: �fx,�, � Zip: ��-�`�?i .
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PERMIT TYPE AND F$E CALCIILATION
MIINICIPAL SEWER CONNECTION ( $30. 00 per stub) $
pipe size inches ; material PVC (on sand fill) ; cast iron
SAC Charge ( $650.00 ) must accompany all sewer permii: applications unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MUNICIPAL WATER CONNECTION ( $30 . 00 per stub) $_
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hal .
( 5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 )
Water meters must be set and sealed by Orono Water Department (473-7357)
upon completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75 '
REQL'IRED setl�ack from sewer iine = 2G `
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1. Subtotal of above permit requested $_
2. State Surcharge . 50
The State Building Code Division Surcharge of „50 per permit must be
included for each well, sewer and water connecti��n permit requested.
3 . Postage & Handling (Only mail-in applications ) $ 1. 50
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 accordance with the ordinances of the City and the
regulations of the State of Minnesota,�and certif' s that al 1 statements made on this
application are complete, true and oorrect.
Signature of Applicant:�-��..��--, - Date: ��— 1-�- - %�
� V
DATE TIME
CITY OF ORONO CALLED IN J�-/�-y�
INSPECTION NOTICE SCHEDULED ��� - i� �-� °�
PERMIT NO. ���� � COMPLETED _�.` ��
ADDRESS l s �6 ��✓�-% �f ���.
OWNER CONTR. G�l�`t-��-
TELEPHONE N0. `���- `� �5 �
� DESCRIPTION �Z"°'`' ti'�'�"`'`^�`"Y`_"�-'�
� 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v PLUMBING FINAL� 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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`RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
�ECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
:T WORK,CALL FOR REINSPECTION TEMPORARY
':OVERING PERMANENT
'NSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
OR WILL RETURN
�STED.CALL INSPECTOR
❑CITATION ISSUED
'11RED.CALL TO ARRANGE ACCESS.
next inspection 24 hours in advance.473-7357
site:
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