HomeMy WebLinkAbout2008-P11898 - sewer & water . � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P11898
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: 3/3/2008
SITE ADDRESS: 2480 Cobblestone Ct Unit#
Long Lake,MN 55356
P��� 33-118-23-11-0079
DESCRIPTION:
Proposed Usc: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate permits requircd:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Groth Sewer&Water OWNER: O.T. Development, LLC
775 Tower Drive 2670 Kelley Pkwy
Hamel,MN 55340 Orono, MN 55356
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 SIGNATURr
Copies: 1-File(Signarures Required), 1-Applicant, 1-Monthly Reports, ]-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY US�ONLY
Cit Of 01'ono Date Received: Pennit#
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�' ,; �� 2750 I�elle} Parkway ❑In-House SAC Determination Form Compieted
����d ���� ����� �ry�s�a�B�a���N 55323 Approved By(If Required): �
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CITY OF ORONO—SEWER & WATER/GENERAL PERMIT
(*Note:Soine permits may require approval by theBuilding Official and/or Pubiic Works Department*)
(ALL PERMITS- Ma�•be subiect to further review and mav not be iccued when the application is received)
GENERAL 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 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 w�less 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)far 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 notice required.
TYPE OF PERMIT
(Check All That A 1 )
� Residential (May Require Approval) � Commercial(Approval Required)
� New Connection ❑ Additional Connection � Re-Connection � Repairs � Disconnect
Job Site/ Owner Information:
Site Address: � � (� � ������ ��� /l� �
Owner: �I�����ti�' Mailinb Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contracto�'.�-�� (� �� �� Contact Person: �� � /
Address:7 7S TC�«-����2 State License #: �/ � �
�-5�v
City: - � Zip. Expiration Date: �� � �� �
Phone: ������J� Alternate Phone: �/ �_ �� J UZ � >
DETERMINING PERMIT FEES
� SAC Charge(2007 Rate=$],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)
� Sewer Conne tion/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 40 air tested; � copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING (Only on Mail-ln 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 permit.
■ V1'ATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter insfallation.
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
Minneso�a, and certifies that all statements made on this application are,true and correct.
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Applicant: Date: �
Reset Form
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CITY OF ORONO CALLED IN �^
INSPECTION N TIC SCHEDULED �' .'..�D
PERMIT N0. �� � COMPLETED
ADDRESS � `t'�D �OC� IPST�riU l`�"'
OWNER v CONTR. �r a��>
TELEPHONE NO. ��3 `�� �7 �L !�/�- 9/9 o z S�,
� DESCRIPTION d���� U G���t C��U�'z�'1,
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP � PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FO�LOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET Y U• YES_NO
� COMMENTS: � ��'�r� '� l� ��rn
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
0 STOP ORDER POSTED.CAIL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (J52� 249-46��
OwnerlContractor on site:
Inspector. l.�� `�� � -�
White Copyllnspector's File Canary CopylSite Notice