HomeMy WebLinkAbout2004-P08263 - sewer connect PERMIT
C I�,,Y O F O RO N O Permit Number:
~2 T50 Kelley Parkway - PO Box 66 Pos263
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: t2�6i2oo4
SITE ADDRESS: 325 Crestview Ave
Long Lake,MN 55356
P I�: OS-117-23-14-0031
DESCRI PTION:
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:
FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Knute Development LLC OWNER: William Sullivan
9982 Arcola Cr.N. 325 Crestview Ave
Srillwater,MN 55082 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEN�NTS SPECIFIED
AND AGREES TO DO ALL W RK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESO BUILDING CO E REQUIREMENTS.
� ` V
I
i
PP CANT PER ITEE S[GNATURL SUED BY SIGNA"I'UR[
Copies: 1-File(Si�nitur-es Required), 1-Anplicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(Updated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box `(2750 Kelley Parkway) SEWER/WATER & SAC
�rystal Bay, MN 55323 �
GENERAL INFORMATION
1. You may apply for utility pennits 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 the same day
the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts 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 Deparhnent. 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.
JOB SITE ADDRESS: �1� � +�{J/ G�' l'. '�''� G � `
Occupancy Type: Residential Commercial
Owner's Name: 'C�� ,,� Phone Number:
Mailing Address: � o� �.t S ,c w 1,'j,, City: Zi :
Contractor's Name: r z o �,,���+ �- �- Phone u ber: �'� �2 G "'— a a�
MailingAddress: �/�"!1 �"yrhG � City: ; Zip: �
PERMIT TYPE Connections �
� ❑Repairs ❑Discoruiect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If'not prepaid, a sewer connection will not be issued)
� �Municipal Sewer onnection/Disconnect/Repair ($35.00 per stub) $ � r
pipe size inches; material 'C- Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
(952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUTRED setback from sewer line= 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well, sewer and water connection permit requested.
3. Postage &Handling (Only mail-in applications) $ 1.50 (Mail In Only)
4. TOTAL PERMIT FEE (add lines 1-3 above) $
The undersigned hereby applies o the City of Orono for issuance of a Utility Permit, agrees to do all work in strict
accordance with the ordinance of he City an the regulations of the State of Minnesota, and certifies that all statements
made on this application are m lete, t a d correct.
�
Signature of Applicant: Date: (�
�� DATE TIME "
CITY OF ORONO CALLED IN la� t
INSPECTION N TIC SCHEDULED �a' %�
PERMIT NO. � a 3 COMPLETED �7-��'�� 'a-�-���
ADDRESS .�S C�2.2L2-�lJ��
OWNER CONTR. !«? �>
TELEPHONE NO. �s�-a �S- 7ad T ��� �c"���5
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK- O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FO�LOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTORTOMEETYOU�YES_NO
� COMMENTS:
� - `� � � SCl u(� � .�C
�
o — fio���C u✓-r- ( ;S�r �r�;� r�..�,. Sc.c� �,�
a � �'
�
� e.� J
�
W
� � i
Q
� �� ,,�
� -- S� ��,��� OI
W +
� i 1 ir'�. t U� �.c.l.f ,�.,� (hJ�I -
�
d
� ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on te:
Inspector. �G��
White Copyllnspector's File Canary CopylSite Notice