HomeMy WebLinkAbout2001-P03803 - sewer/water connect PERMIT
C I TYR U F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P03803
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: s��ai2ooi
SITE ADDRESS: 3349 Crystal Bay Rd
WAYZATA,MN 55391
P I D: 17-117-2 3-41-0023
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit T e: Sewer and Water Per►nit Permit Sub-type(s): Sewer Connection
Yp Water Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTIC ES/REMARKS:
FEE SUIIIIMARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Sandd Excavating OWNER: ACE PROPERTIES LLC
10393 Quail Creek Drive 3349 CRYSTAL BAY RD
Blaine,MN 55014 WAYZATA MN 55391
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 C REQUIREMENTS.
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ArrLICANT ERMITEE IGNATURE ISSUED SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
'Ci�'Y'OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
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 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 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) 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 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: 3 �/ � S }z'+ I �a ��
Occupancy Type: Residential Commercial
Owner's Name: ` ( ,, ,' �„ Phone Number:
Mailing Address: City: 7�•
Contractor's Name: pi � C, Phone Number:(7�a� 7�'p-3 Cr0 �
MailingAddress: 1-�p�l� (4tia r � rdcc � City: Gl���-. 7�: S�
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PERMIT TYPE
Municipal Sewer onnection ($35.00 per stub $
pipe size�inches; material�Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
Municipal Water CQnnection ($35.00 per stu ) $
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'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surchazge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage & Handling (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 Utility Permit, agrees to do
all work in strict accordance with the ordinances of the Cit� and the regulations of the State of
Minnesota, and certifies that all statements m n thi piication are complete,true and correct.
Signature of Applicant: Date: �L