HomeMy WebLinkAbout1993-005820 - sewer connect �+ �� PEI�MIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 =�`�.'._."_.�, k�j i�."�s ��_i-;
Orono, Minnesota 55356-0815 Permit Number: ;:;,_�,;,y;::,�_;
(612) 473-7357 Date Issued: j ^:: ;_ Y: :,-��::
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE .L—��
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� , CITY OF ORONO APPLICATION FOR UTILITY PERivIITS �'�z�C
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 5�323
GENERAL INFOR�'�IATION
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 fees shown below. Pemut cards will be sent
by return mail the same day the application is :eceived.
3. Permits are not valid until you receive a per��it c�rd.
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 (473-7357)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 pernut 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 hour notice required.
JOB STTE ADDRESS: � .� � �-���" ���
Occupancy Type: Residential Commercial
Owner's Na.�ne: � PhoneNumber:
Mailing Address: - � .�-- ,�-� City: 7ip:
Contractor's Name: PhoneNumber: �y�J /��S`-
Mailing Address: ` City: 7ap: ,S"�'��� ^
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size �1 _ inches; material+'`R/� PVC (on sand fill); cast iron
SAC Charge ($750.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
�4VATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department (473-735'� upon
completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQLTIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
l. Subtotal of above permit requested �
2. State Surchar�e $ .50
The State Building Code Division Surcharge of�.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Postage & Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) �
The undersigned hereby applies to the City of Orono for issuance of a Utiliry 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 complete, true and
conect.
Signature of Applicant:_������2�j��-�� �: /� - /�_ _�
DATE p7 TIME
CITY OF ORONO CALLED IN /�—�� � v
INSPECTION NOTICE SCHEDULED � � '2c` i/ : 3 d
PERMITNO. -� ��� COMPLETED � L-L�-73 / 3{�
ADDRESS ,� �7-s C�.�c� �c)
OWNER ���i'�.�u�-rc� CONTR. `iL' C C�vi�ce�tJ
TELEPHONE NO. �`�� —� �9 S
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SET(fURN ON 17 SITE INSPECTION
� 07 DEMO—SITE SEWER HOOK-UPr 06 PROGRESS
� 07 DEMO—FINAL 2 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOWUP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance.473-73�J7
OwnerlContractor o ite:
Inspector. �� ---�
White Copy/Inspector's File Canary CopylSite Notice