HomeMy WebLinkAbout2005-P09351 - sewer connection � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p09351
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued:
10/25/2005
SITE ADDRESS: 1640 Bohns Pt Rd Unit#
Wayzata,MN 55391
PID: 16-117-23-22-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Grandfathered In-#2567- 10/28/70
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Freedom Mechanical OWNER: Scott Ross
11135 Hwy. 7 2411 Lorien Street
Watertown,MN 55388 Minnetonka,MN 55305
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 PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
FOR C1TY USE ONLY
� City of OrOno Date Received: Permit#
O4 '�� P.O.Box 66
�,,;:,,, 27�0 Kelley Parkway ❑in-House SAC Determination Form Completed
a� ���`y'?A;z;-� �+• Ciystal Bay,MN 55323
� 'Tt� �'s�..o"' (9�2)249-4600 Approved By(If Required):
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CITY OF ORONO-SEWER& WATER/ GENERAL PERMIT
(*Note:Some pennits may require approval by the Building Offlcial and/or Public Works Department*)
(.4LL PER1�11TS- iltav be subiect to further review and mav not be issued when tlte annlication is received)
GENERAL INFORMATION
1. You may apply for utility pernuts by mail or in person at the City offices.
2. Mailed in applications are subjeet to the postage and handliizg fee shown below. Pernut cards will
be sent by return mail within 2 business days.
3. Permits are not valid until you receive a pernut card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection permits may be issued to licensed conh-actors 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 pennit 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.
' TYPE OF PERMIT
(Check All That Apply)
�Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑Additional Coimection �Re-Connection ❑ Repairs ❑ Disconneet
Job Site/ Owner Information:
Site Address: ����� /�vhr✓-3 G�� ,/r�`
Owner: ,��� `17�/��S Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �/�es�o-� ���C���c- Contact Person: ����` /`���
Address: ll/3,S State License #: �-- '�/D yiZ
City: !�'I/� /�� �k'�'�' Zip:;S��Expiration Date:
Phone: �'�a-5'yG �-�,��( Alternate Phone: �lrZ ,3�� ��1� ��l
DETERMINING PERMTT FEES
❑ SAC Charge(2005 Rate=$1,450.00) $
(SAC Charge tnust accompany all sewer permit applications unless prepaid)
(Orono City Staff can deternune if applicable)
(If not prepaid, a sewer connection permit will not be issued)
❑ Sewer Connec ion/Disconnect/Repair($35.00/Per Stub) $
Pipe size�inches;material Schd 40 air tested; cast iron
❑ Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd a0 air tested; copper
1. SUBTOTAL of Perinit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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 pernut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
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.
�,� —
Applicant: , �!����-c� Date: �C� 5
� �( '(� DATE TIME
CITY OF ORONO CALLED IN '�ILS ��
INSPECTION NOTIC �j � SCHEDULED T���-`' �
PERMIT NO. ✓� COMPLETED � ✓
ADDRESS � '`�L �� �
OWNER CONTR. �
TELEPHONE NO. �5� T T�=g���
� DESCRIPTION --��3-YI�--
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
r 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑C RRECT WORK&PROCEED ;-', ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDlTION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46�0
OwnerlContractor site:
Inspector. `�
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