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Home My WebLink About2000-P02764 - sewer connection t '� � PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po2�6a Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit (612) 249-4600 Date Issued: giii2000 SITE ADDRESS: 3800 Dickson Extension SPRING PARK,MN 55384 PID: 17-117-23-31-0020 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Sub-type(s): Sewer Connection Permit Type: Sewer and Water Permit DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: � 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 SAC Fee: $ 1,100.00 TOTAL FEE: $ 1,135.50 APPLICANT: HAROLD E. DAY& SON INC OWNER: GEORGE P OBRIEN ETAL 410 NIAGRA LA 3800 DICKSON EXTENSION PLYMOUTH,MN 55447 SPRING PARK MN 55384 -�� 3� s s k- ?a�i� 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 ST TE OF MINNESOTA BUILDING CODE REQUIREMENTS. i � �� / APPLIC T PERMI EE SI URE ISSUED BY SIGNATURE Copies: City,Applicant,Assessor, inance Page 1 � � w CITY OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SEWER/WATER Crystal Bay, MN 55323 GENERAL INFORMATIOiv 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 fees 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(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. Ca11249-4600. 24 hour notice required. JOB SITE ADDRESS: �,��(�d �.�GD�avev�� ► l�vi�/ �� Occupancy Type: ✓ Residential Commercial Owner's Name: (�2.o C /�Gv�G�-S Phone Number: Mailing Address:� City: 7�p: Contractor's Name: ¢.- Phone Number• Mailing Address: � itJ City: P� �- �� PERMIT TYPE Municipal Sewer Connection ($35.00 per stub $ pipe size inches; material ��Schedule 40 air tested; cast iron SAC Charge (200�e $1,100.00) must accompany all sewer permit applications unless prepaid. If not prepaid, a sewer connection permit will not be issued. Municipal Water Connection ($35.00 per stub) $ 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(249-4600)upon completion of ineter installation. REQUIRED minimum setbacks from drainfield 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 Surcharge of$.50 per permit must be included for each well, sewer and water connection permit requested. 3. Postage & Handlin� (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 City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete,true and correct. , � � � �-�� Signature of Applicant: Date: . � � � �;; MINNESOTA DEPARTMENT OF HEALTH - BONDING AND INSURANCE CERTIFICATE �� ;,�; , � if�is is to certify tf�at Harold E. Day master plumber License No. PM002083 �i�� , r�epre�cnting Ilarold E. Day & Son. Inc. . has filed a $25.000 bond with the �;;! Secret��ry of Stai:e on Januar�y ?1 , 2000: and provided evidence of Public ''� I_iahi 1 ity Iri�t�rar�ce wiLh 1 irnits of at least $50.000 per person, $100,000 per I�i occurrence, arici �10.000 pro�erty damage for the year 2000 in accordance with tf�e �r��vis�ir�n; o( Minn��sot�� St��ttates . Section 326.40 (1978) . � QONU NU. RLI 516��91 Policy N0. BDN0265290 02 Old Repuf�lic Siirel-.y Comp��riy West Bend Mutual �� De; Moine� , Iowa Cully Quranen. Minnesota Agent ;� Eil oomi ngton. Mi nnesota '�' �il MIZ il/11�ULU f_ U�1Y 'i; H/1RUL D E. D�Y & SON, 1 NC. ��, �. ��;�e�M � �110 Ni�GR/1 I_/1NE �"-�^ PLYMOII�I I MN 554�17 Patricia A. Qloomgren, Director Division of Environmental Health '.;; ,, � Jan K. Malcolm. Commissioner '1' � 'i ' 'i;j �i �, . ;, i�� , .. _'' , m � L� . , � � � �� m �, o « � W . ►� � ,, t� r� � F,. 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J �i (�t •• U '-/ � � C.J � �� y � � a W � .��C.7�-]�"_�w�G-7��-7A-�T'�t-.'11�_71�C=.�IR�"- (� DATE TIME CITY OF ORONO CALLED IN V �� a I� INSPECTION NO ICE SCHEDULED � � PERMITNO. a7�� COMPLETED �_y�� ' � ADDRESS 3 1C�� -� � OWNER CONTR. ��n TELEPHONE NO. �'I�I�� DESCRIPTION LV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP ) 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATIO /REMOVAL J � OWNERICONTRACTOR TO MEET YOU:_YES_NO '� � COMMENTS: �� W a j � O a � � O � W � ac �.. Q I� '� -(C Z W � W � j d �WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W � ❑CORRECT WORK&PROCEED 1-� ISSUE CERTIFICATE OF OCCUPANCY W Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT Cl CORRECTUNSAFECONDITIONWITHIN HOURS. -, PHOTOTAKEN INSPECTOR WILL REfURN f�STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED i; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection24 hours in advance. 249-46�� OwnerlContr tor on site: Inspector.,�2.�G�� White Copyllnspector's File Canary CopylSite Notice