HomeMy WebLinkAbout2006-P10655 - sewer/water connect , PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PO Box 66 P1o655
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 12/29/2006
SITE ADDRESS: 3345 Crystal Bay Rd Unit#
Wayzata,MN 55391
PID: 17-117-23-41-0022
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pcrmit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
Water Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Westonka Sewer&Water OWNER: Rudy Wicklander Homes,Inc.
6501 Co. Rd 15 15440 Potawatomi Street
Mound,MN 55364 Andover,MN 55304
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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APNUCANT PER E SIGNATURE , `ISSUED BY SIGNATURE. r
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
.
FOR CITY USE ONLY
40� City Of Ot'ono Date Received`. , ' Permit#
P.O.Box 66
��,, � 2750 Kelley Park�vay ❑ In-House SAC Determination Form Completed
a '�1���'� �. Crystal Bay,MN 55323
�'� �° � �� o'' 952 249-4600 Approved By(If Required):
t��ti��,$4 � � � . .
CITY OF ORONO—S�WER&WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Buildii�g Oflicial and/or PuUlic Works Department'`)
(ALL PER�9ITS- A7av be subicct to further review and mav not be issued when the annlication is recci��ed)
GENERAL INFORMATION
1. You may apply for utility pennits by mail or in person at the City offices.
Z. Mailed in applications are subject to the postage and handling fee shown below. Pernut cards will
be sent by rehirn mail witl�in 2 busuless days.
3. Pei•mits 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 perniits may be issued to licensed conhactors or�ly.
6. Contact the Public Works Department(952-249-4600) for utility shib as-built locarions.
DO NOT ElCAVATE In ANY STIZEET AND DO NOT TAP ANY MAIN without express
approval of the Public Vb'orks Department. Issuance of a pemut does not grant this approval.
7. All work must be done in accordance with State Code requuements.
S. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required.
TYPE OF PERMIT
(Check All That App1Y)
�Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑Additional Connecnon (�'ke-Connectioii ❑Repairs ❑Disconnect
Job Site/ O�vner I�iformation:
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Site Address: �� � � �� � ��-� � �� - ��" ,
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
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Contractor: .,) ,S�i<�1�s � Contact Person: �����'' G'��
Address: ����i( C��• `�'�y • L`� State License #: (��`i�'�
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City: �/�l ' �-�l Z:p:`�5��'�Expiration Date: �-2- �i z'�
Phone: �c(� � � u 7�-y 7 S� Alternate Phoile: � �--� �`��l ���
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- '`'� DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can determule if applicable)
(If not prepaid, a sewer connection permit will not be issued)
,`���]�w�r Connection/Disconnecf/Repair($35.00/Per Stub) $
� Pipe size�inches;materia��Schd 40 air tested; cast iron
VVater Conne ti�si/Disconnect/Repair($35.00/Per Stub) $
ipe size�inches; material Sclrct�0"�r�tested; copper
Y°���.
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1. SUBTOTAL of Pernut Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&:HANDLING(Only on Mail-I��Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
ADDITIONAL INFORMATION-WATER ttiIETERS
■ 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 VVater Department (952) 249-4600, upon
completion of ineter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Pennit, agrees to do
all work in shict 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 conect.
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Applicant: �- Date: ��' �� ���
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DA,/TE � TIME ��
CITY OF ORONO CALLED IN l � O � u �
INSPECTION NOT CE SCHEDULED ��/'D7 '�7
PERMIT NO. f���<r`�5 connP�ETE�
ADDRESS ����I�S C/'� S�h� ,1�� /�-�.
OWNER CONTR. GC�� SIZk- l�=c1---
TELEPHONE N0. � �`� �� � ���7 l
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� DESCRIPTION �---�,c.�C /' '� LU��—��_%� �c���1���-t-
� 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING Rf 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali tor the ext inspection 24 hours in advance. (952) 249-4600
OwnerlContr n site:
Inspector.
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