HomeMy WebLinkAbout2007-P11225 - sewer disconnect PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11225
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
7/18/2007
SITE ADDRESS: 1595 Bohns Pt Rd Unit#
Wayzata, MN 55391
PI D: 08-117-23-44-0024
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer Disconnect
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Freedom Mechanical OWNER: William Cornelius
11135 Hwy. 7 100 NE 2nd Street#510
Watertown, MN 55388 Minneapolis,MN 55413
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT YGRMITEE SIGNATURE ISSUED BY SIGNATU E
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, (-Assessing,(If Septic, 1-Septic) Page I
, .
FOR CITY iJSE ONLY
,�Q� City of Orono Date Received: Permit#
� P O.Box 66
��;; �� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
��� �t?� R,` �. Crystal Bay,MN 55323
�t"��x��t�.�.}yL`l (952)249-4600 ApprovedBy([fRequired):
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CITY OF ORONO— SEWER & WATER/GENERAL PERMIT
('`Note:Some permits may require approval by the Building Official and/or Public Works Department*)
(ALL PF,RMITS- Mav be subiect to further review and mav not be issued when the application is received)
GENERAL INFORMATION
l. 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 fee shown below. Permit cards will
be sent by return mail within 2 business days.
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(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 Department. 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 notiee required.
TYPE OF PERMIT
� � ��� (Check All That A � l )
�Residential(May Require Approval) � Commercial (Approval Required)
� New Connection ❑ Additional Connection � Re-Connection �Repairs ❑ Disconnect �
Job Site/ Owner Information:
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Site Address: � � � ���y
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Infor�nation:
Contractor: }%�z--1 ��-��� Contact Person: �Z��C �� /��
Address: ��� State License #:
City: � Zip:����` Expiration Date:
Phone: �_S� y`��p�vzy Alternate Phone:
�'�,z 363��1 YE�
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' DETERMINiNG PERMIT FEES; �' �
� SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
,�ewer Connection/Disconnect/Repair($35.00/Per Stub) $ �3�'�"
Pipe size inches; material Schd 40 air tested; � cast iron
❑Water Connection/Disconnect/Repair ($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; 0 copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �������
ADDITIONAL INFORMATION - WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installatioo.
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,true and correct.
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Applicant:_✓ � ��g���-��c Date: l�E��(U�
Reset Form
t� � AT TIME �
"CITY OF ORONO ALLED IN C��
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. ��COMPLETED
ADDRESS -�J
OWNER CONTR. ���
TELEPHONE NO�w1 E��� �� �� ` 7 �?C�
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� DESCRIPTION _C51� C 7�"
ly� 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 REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEP FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: ES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL tNSPECTOR ❑ CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ext inspection 2a hours in advance. (952� 249-4600
OwnerlContr site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice