HomeMy WebLinkAbout2006-P09957 - sewer/water disconnection � f � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p09957
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
6/7/2006
SITE ADDRESS: 2445 Dunwoody Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-22-0011
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Disconnecti<
DETAILS:
Approved perresolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: J.S. Stewart Companies OWNER: Mark Schuehle
11099 Lamont Ave. 2445 Dunwoody Ave
Hanover,MN 55341 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 CODE REQUIREMENTS.
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A LICANT PERM EE SIGNATURE 1SSUED BY SIGNATURE "
Copies: 1-File(Signatures Reguired), 1-Applicant, I-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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� � ' PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PO Box 66 Po9957
Crystal Bay, Minnesota 55323 Permit Type:
Sewer and Water Permit
(952) 249-4600 Date Issued: 6/�/2006
SITE ADDRESS: 2445 Dunwoody Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-22-0011
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Disconnectic
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: J.S. Stewart Companies OWNER: Paul&Leann Hanssen
11099 Lamont Ave. 2118 Shadywood Rd
Hanover,MN 55341 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 CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Sigriatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
��,�` Clty of Orotlo Date Received:L ( �t Pern»t# , �X �
O a `rO P.O.Box 66
(� �,,ti„ 2750 Kclley Parkway ❑In-House SAC Deterniination Form Completed
a j!`:'�,�'�- � Crystal[3ay,MN 55323
�a �'��'''a o`� 952 249-4600 Approved By(If Required):
t 1,;�,hr��;�y ( )
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CITY OF ORONO —SEWER & WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
(ALL PFR�IITS- Mav be subiect to further review and mav not be issued�vhen the apnlication is received)
GENERAL 1NFORMATION
1. You may apply for utility pei7nits 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 rehun mail�vithin 2 business days.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility comiection perinits may be issued to licensed conn�actors only.
6. Contact the Public Works Department(952-249-4600) for utility shib 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+liour notice required.
TYPE OF PERMIT
(Check All That Apply)
�esidential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs �Disconnect
Job Site/ Owner Information:
Site Address: �T T S ,�UN wGQ� �! �
Owner: SiJti/C���T �ui�c`�r�ZS Mailing Address: (�51�;3 ���L.F T i ��-v�
City: /vlo��N� _ Zip: J����`-�4
Home Phone: Alternate Phone: (,(Z Z�O �-��`�' �
Contractor Information:
Contractor: J `� `��a�Zi ��J��l��S Contact Person: ,�n�i :S�T�w��Z-r
Address: IIU�`t �+/y'orvr v�- State License #: � C��
City: �/�JNl1VF_� Zip:��{( Expiration Date: �1 �R
Phone: �4� � �f2�1 �1t�3C7 Alternate Phone: fo/Z- ��(�(�' �v8ll
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DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid, a sewer connection permit will not be issued)
�Sewer Connection/Disconnect/Repair(�35.00/Per Stub) $
Pipe size inches; material Schd 40 air tested; cast iron
�,�Vater Connection/Disconnect/Repair($35.00/Per Stub) �
� Pipe size inches; material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) �
ADDITIONAL 1NFORMATION—WATER METERS
■ 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 Water Department (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 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 thi,s application are, true and correct.
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Applicant: Date: l� ^ —�
�ATE/� TIM
CITY OF ORONO LLED IN
INSPECTION N TIC SCHEDULED ��;�=J J _ ,
PERMIT NO. ��� COMPLETED
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ADDRESS �
OWNER CON . ��S �YT�
TELEPHONE NO.
� DESCRIPTION <��'�%��- �S���n'k-Q �
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL 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 14 SEWER 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 �0 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ C RECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED
❑ INSPECTION REQUIRED.CA��TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-460�
OwnerlContractor on sit •
Inspector. / i � rJ
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