HomeMy WebLinkAbout2000-P03358 - sewer connect .
� - � PERMIT
CIT'�,� OF ORONO Permit Number:
2r�� Kelley Parkway - PO Box 66 P03358
Crystal Bay, Minnesota 55323 Pe►'mit Type: Sewer and Water Permit
(612) 249-4600 Date Issued: 12i�9i2o
SITE ADDRESS: 430 [.ong Lake Rd E
WAYZATA,MN 55391
PID: 35-l 18-23-14-0005
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution #:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: w�DMER INC OWNER: LO[S M STURMAN
BOX 219 430 LONG LAKE RD E
ST. BON1, MN 55375 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TOMAKE 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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APPL[CAN"I'PGRM[TEE GNATURE �'� SSUED BY SIGNATURE
Copies: City,Applicant, Assessor,Finance Page 1
.
� _:;T�: OF ORONO APPLICATION FOR UTILITY PERMITS ��j
- ,Box 66 (2750 Kelley Parkway) SEWER/WATER ��'�j� '
. Crystal Bay, MN 5�323 �
GE1vERAL 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 handlin�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.
�. 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
Deparhnent. 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: ��� ���s� ��,r ����' �u-��f`
Occupancy Type: �- Residential Commercial
Owner's Name: �o,:S S��2..��--�/ Phone Number:
Mailing Address: %3o f—�,�i �/�.r�� �.A�� City: (`,i�yv 7ap:
Contractor's Name: Gc.J�c%rye� ��✓� Phone Number: ��- S/�- /sijs"�
l��ailing Address: �v �o.x. �/S City:Si'"�-�1 Zqr. S-��y�
PERMIT TYPE
�Iunicipal Sewer Connection ($35.00 per stub) $
pipe size�inches; material�chedule 40 air tested; cast iron
SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
1�Iunicipal`Vater Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
`Vater 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
l. Subtotal of above permit requested $ , ` � � r�`>
...� _�
2. State Surchar�e $ .50
The State Buildin�Code Division Surchar�e of$.50 per permit must be
included for each well,sewer and water connection permit requested. ;\
3. Postage & Handlina (Only mail-in applications) $ . 0 �'�
4. TOTAL PERMIT FEE (add lines 1-3 above) $ ' 2� � �
The undersigned hereby applies to the City of Orono for issuance of a Utility Permi�; agrees to do
all �vork in strict accordance with the ordinances of the City and the regulations of the State of
�linnesota, and certifies that all statements made on this application are complete,true and correct.
Signature of Applicant��a�n� /��4��� Date: //���
DATE TIME
CITY OF ORONO �> CALLED IN
INSPECTION NOTICE ,,�� SCHEDULED
PERMIT N0. r� COMPLETED �'��'�'� I O'�L��
ADDRESS � Sa ��+Si' Lc��,�� L��k� IC�9C,
OWNER CONTR. W ��MZ r
TELEPHONE NO.
� DESCRIPTION
� O7 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIAEPLACE 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 COMPIAINT
� 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
� OWNE CONTRACTOR O MEET YOU:�YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WtLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-4600
OwnerlConUactor on site•
Inspector. ���� , �`��
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