HomeMy WebLinkAbout2004-P07752 - sewer repair � � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Po��s2
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: �i2�i2ooa
SITE ADDRESS: 3435 Crystal Bay Rd
WAYZATA,MN 55391
PID: 17-117-23-43-0120
DESCRIPTION:
Proposed Use: Residential
Permit Class: General.
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Perniit Fee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Roto Rooter Services Co. OWNER: SCOTT A BROWN
14530 27th Ave.N. 3435 CRYSTAL BAY RD
Minneapolis,MN 55447 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO O ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA B DING CODE REQUIREMENTS.
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PPLI NT PERMITE:E SIGNATURE ISSUED BY SIGNATURE
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Conies: 1-File(Siznitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
(Updated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER & SAC
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. Pernut 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 pennit card is available on the job site.
5. Utility coiuiection pernlits may be issued to licensed contractors only.
6. Contact the Public Works Deparm7ent(952-249-4600)for utility stuU 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 pemut 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: �y3� C,����l ���� �G�'
Occupancy Type: �l3,esidential Commercial
Owner's Name: SCo� L5`��w✓' Phone Number: �'jS�?- Y7/- �yS�
Mailing Address: � � C�'�•5�.�? B�� w�� City: d��•�� Zip: S�35/
Contractor's Name: c� - o��r Phone Number: 7�3 - �%�- 35ds'
Mailing Address: %Y�3� ,��� � �- City: < <'►'t���� Zip: 5 5 yY7
PERMIT TYPE ❑Comiections `�Repairs ❑Disconnect (Check One)
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SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge inust accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconne epair 35.00 per stub) $
pipe size inches; material d 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; inaterial 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
l. 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 pernut requested.
3. Postage & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only)
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 City and the regulations of the State of Minnesota, and certifies that all statements
made on this application are co 1 e,true and c rrect.
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Signature of Applicant: e'`� Date: �" ( �� d/
�� J J DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED � r -30 �
PERMITNO. 7�5� COMPLETED 7�� ` ^�3n �
ADDRESS �-I3�J C��-f S� ��-� �f����t � -
OWNER CONTR. ��'� � - �
TELEPHONE NO. 7�_P� ':� �LQ` �c�`"1 j �JICIi �
� DESCRIPTION �,2.� 1��� �'L��i,�'
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� 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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W� ❑WORK SATISFACTORY:PROCEED [yR(tOJECT COMPLETE
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W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CAIL INSPECTOR �-� CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlCon ctor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice