HomeMy WebLinkAbout2003-P06843 - sewer/water connect . .
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po6s43
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: io�i�2oo3
SITE ADDRESS: 3329 Crystal Bay Rd
Wayzata,MN 55391
P I D: 17-117-23-41-0019
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Pernut Type: Sewer and Water Pernut Pernut Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PerniitFee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: V P Enterprises OWNER: Sevie Lanning
P.O.Box 15 3329 Crystal Bay Rd
Wayzata,MN 55391 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
/ _.__� -
__
--� _ _. i�,'
" '
. � ' �.
.
. --� � �`i �i1 �'� �-� I��-- � l�.
APPL[CANT PE EE'SIGNATURE !�ISSUED BY SIGI�'ATURE
Copies: 1-File(Signitures Repuired), 1-Anplicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
.. • (Updated 6/2/03)
CITY OF OROl\'O APPLICATION FOR UTILITY PERMITS
BoY 66 (27�0 Kelley Parkway) SEWER/WATER& SAC
Crystal Ba�•, N1N �5323
GENERAI.L�FORtiiATION
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. Pemut cards will be sent by retum mail the same day
the application is received.
3. Permits are not valid until you receive a permit card.
-�. Work must not begin unless the pernut card is available on the job site.
5. Utility connecrion pernuts may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locarions. DO NOT EXCAVATE IN ANl'STREET AND
DO�OT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernut does not gzant this approval.
7. All w�ork must be done in accordance with State Code requirements.
`s. All���ork must be inspected before it is covered. Call(952)249-4600,24 hour notice required.
J OB SITE :�DDRESS: �r� �- C � �!�-� � �
�ccupanc��Type: �Residential Com ercial--
��vner's Name: , � � � �-�-Y� U'� Phone Number:..-���"���
:�tailing Address: v�'Y -S �� L� City: �--����" Zip•
�Contractor's Name: ;� �-� ��- Phone Number: ��2 Gks-���S«>
i`Iailing Address:�r ��,� /S ' City: (��� 2.� Zip• ,5��?�/
Pi RI�IIT TYPE �"Connections ❑Repairs ❑Disconnect (Check One)
S aC Charge (2003 rate $1,275.00) $ �/ C`'�--' (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
f If not prepaid, a sewer connection will not be issued)
� S � ��''
Nlunicipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size� inches; material l�L Schd 40 air tested; cast iron
,�Iunicipal Water Connection/Disconnect/Repair($35.00 per stub) $ � _S , �i c%
pipe size�inches; material �--'S copper; other
WATER METERS must be picked up and paid for at City Hall.
�`>'ater meters must be set and sealed by Orono Water Department
'"°i�2-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line = 20'
ERI�IIT FEE CALCULATION �c U�
.. Subtotal of above permit requested $
�. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of 5.50 per permit must be
included for each well,sewer and water connecrion permit requested. .
3. Postage & Handlin�(Only mail-in applications) $ (Mail In Only)
�. TOTAL PERi'�IIT FEE (add lines 1-3 above) $ �� � �7U,�__.
�,he undersi�ed hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work in strict
_ccordance�vith the ordinances of e City and the regulations of the State of Minnesota, and certifies that all statements
�ade on this application^ compl , rue and correct.
;- ------__ _
_ .._.._--—.�___
�---�
Signature of Appl'' –Date:-- ��^���2`�'�3
i
ir?
;:. ��-��G'� 3
; � r �
�
� -_---_ ._�. ,-, Gl,/� ��, �,,,� �►� �� 79-�" ,� t
�
�"
_______�____ _��_____ :.:., � '�� �� C �c� S'��- � �
�J � .
��.�.__^._._.'_._. .�. �.. �C/r / �2�J T�/ �G r�/� ���
.� l .
�
- .__.____-__�_-__w_ __. ��: _ ,�� ���� �� ��j�
-�-- _ __ ---.___ _ ...
`� �
�_------------------- �.. �� G�C �'r�4� �1 � �.��c� o-.-/s, ��
/
�
-�.^______.._..�_ �_. � � -s �� � ����
1
��_�-.� .+.. ,���/ �'����.5���%
. ���
�
.� .. `
I�
�� �
_ ��9���-
.
_..___ _______ _ ___ _ __ __
_�._____ . _ ___� _�_______._ _ ___ _______________