HomeMy WebLinkAbout2007-P10842 - sewer connection - PERMIT
CITY OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P1o842
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: 3/22/2007
SITE ADDRESS: 755 Dickey Lake Dr Unit#
Long Lake,MN 55356
PID: 34-118-23-22-0009
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Pernut Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Paid-#5030-06/03/1983
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: VOLKENANT INC OWNER: Terrance&Mary Esau
1030 CO RD 83 755 Dickey Lake Dr
MAPLE PLAIN,MN 55359 Long Lake MN 55356
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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APPLICANT PERMITEE SIGNATURE ISSUED BY G�ATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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'� City of Orono Date Received: Perntit#
„%/�¢��\`` P.O.[3o�66
(��t;,,.,� Q��7 27�0 helley Parkw�ry ❑In-House SAC Determin tion Form Completed
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���K�xp4�o i (9�?)249-4600 Approved By(If Rcquired):
CITY OF ORONO— S�WCR & WATER /GEN�RAL P�RMIT
('\otc:Somc pern�its may rcquirc approv�l by thc Building Ofticial and/or Public Works Departmcnt*)
(;\LL PGR\II"I S- �lat 6c suhiect to furtl�cr revic�� :�nd m;i�'not be issuecl�tihen the;�t��>lica�ion ic recci��ed)
GENERAL INFORMAI'ION
1. You may apply for utility permits by mail or in person at the City offices.
� 2. Nlaifed in applicatioiu are subject to the postage and handlii�� fee shown below. Permit cards�vill
be sent by ret�u�n mail within 2 business davs.
3. Permits are not valid witi!you receivc a permit c�rd. �
4. ���orl: must not begin unless the pennit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
G. Contact the Public 4Vorks Departn�ent(952-249-4600)for utility stub as-built� locetions.
DO NOT E\CAVATE ln`r�nY STR�ET ANU DO NOT 1�r1P ANY I��IAIN without express
approv�l of thc Public �Vorl:s Dep�rtment Issuance of a permit does not grant this lpproval.
7. All worl:must be done in accordailce with State Code requirements.
$. All worl:must be inspected �efore it is covered. Cafl (9�?)?�i9-=}ti00,24+hour eiotice requirccl.
TYPC OP PERNIIT
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�Residcntial (I�9ay Reqtiire Approvll) � Commercial (Approval Required)
�\'e�i�Connection �, Additional Connection � Re-Connection �OJ Kepairs � Disconnect
Job Site/ Owner Information: I
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Site Addcess: � 's I � �� ���-- , j�l� { �����JJ��=
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U���i1er. �£��'+�Atil',� �- �lJ�. ivlaiiiil� Aciciress: ��,� !�� '�� �� �
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City: b�C�v1�: 7ip: �`�����
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Hoi��e t'ho��e: �^ Alter�late Phone: �
� Contractor Information: I
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Contractor: � ( � �� Coiltact Person: �� �)�`�"�C�
Addi-ess: ������ � � �"J State Liceilse #: � � �1
City: � 7ip;j�;���piration Date: i Z—D�
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f 11onc: � Alt�ernate Pllone: �-_�-� 5 7
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DETERMINING PERMIT FEES
� SAC Chaige(2007 Rate=$1,G7�.00) �
(S.AC Charge must accotnpany all sewer permit applications tinless prepaid)
(Orono City Staff can dctermine if applicable)
(If not prepaid,a sewer connection permit will not be issuecl) ���
� Sewer Conn ction/Disconnect/12e�air(�3�.00/Per Stub) � � � �
Pipe size inches;material�Schd 40 air tested; �_cast iron
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❑� �Vater Connection/Disconnect l 12epair($35.00/Per Stub) �
Pipe size iilches; material__Schd=10 air tested; 0 copper
1. SUBTOT�IL of Permit Requested: $
2. STATF. SURCNARGE �_ •��
3. POST�IGE&Hf1NDL1iJG (Oniy on blail-In Appiicatioils) S 1•5�
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=4. TO"€'AL PF.I2MIT F�E (Add Lines 1-� Above) � ��
ADD[TIONAL iNFORMATION —WA�CER M�TERS
� �'1'A"CER�1ETERS must be pickcd up and paid for at Orono City Hall,these are on a separate permit
� lV:�,T�R I�IETERS m��st �e set and sealed by Orono «'ate�� Dep�►•tment (952) 249-4600, upon
completion of ineter installation. �
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all ���orl: in striet accordance with tl�e ordinances of the City and tlle regulations of the State of
Minnesota, and certifies that all statements made on this application are, true and correct. �
Applicant: � � c��Lt�..�.�s Date: � –. 2 Z —Q �
Reset Form
DATE TIME �/
CITY OF ORONO CALLED IN
INSPECTION NQ�ICE SCHEDULED
PERMIT NO. /r��8��'� COMPLETED �� I��� �_
ADDRESS 7 S S O : C K¢�( 1 E} �Q D('.
OWNER L�.S4J CONTR. g. [/0 1 K��,a�tT
TELEPHONE N0.
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICA�FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL �NER HOOK-UP �� � 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑ ORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. `, pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContractor on site:
Inspector. �o� /'� � �
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