HomeMy WebLinkAbout1993-005041 - sewer connection PEI�MIT
GITY OF ORONO PERMIT TYPE: ,_;L��� Y{ ���_��
� z7�0 Kelley Parkway • P.O. Box 815 Permit Number: r.'lt;�,;�:��
Orono, Minnesota 55356-0815 . _.
(612) 473-7357
Date Issued: i_}�j c_;��;,;�=;:;
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APPLICANT/PE ITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (1335 So Brown Rd) SEWER WATER
� �rystal Bay, MN 55323
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I: You ma�pp�for utility pezm.its by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees shown below.
Pezmit cards will be sent by return mail the same day the application is received.
3. Pern�its are nat valid imtil ynu reoe.ivae a pe�it 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 (473-7357) for utility stub as-built locations.
DO NC7I' EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the
Public Works Depart�nt. Issuance of a permit does not grant this approval.
7. All work must be done in accordance wi.th State Code requirements.
8. Al1 work must be inspected before it is covered. Call 473-7357.
24 YxRar notioe rt�t�i red.
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JOB SITE ADDRESS: -� � ,3'� c=/L .E'�-'. l �
Occupancy Type: j' Residential Commercial
OWNER'S NAME: S %�'� � �_� L� � T ��'--' � Phone No. :
Mailing Address : � C- � � � �_' �� �`t,�. City: ������-��, �� �
CONTRACTOR'S N�: ���"�'C ��. " /�+'?/ �-s���� � `i>.,' � ��
Bus . Phone: �'" i T
Mailing Address: ,�,� � ��"1/:r� i���«._ City: � .� � c. �' =k.�-Zip: s;,s'�
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��,.�. PERMIT TYPE AND FEE CALCIII,ATION
� MiTNICIPAL SEWER CONNECTION { $�6-6�6 per stub) $
pipe size �I inches; material��'�� y��PVC (on sand fill ) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MLTNICIPAL WATER CONNECTION ($30. 00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133 . 00; 3/4" meters = $181. 00 ; 1" meters = $235. 00)
Water meters must be set and sealed by Orono Water Department (473-7357)
upon co�pletion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75 '
REQUIRED setback from sewer line = 20 '
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1. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must e
included for each well, sewer and water connection permit requested.
3 . Postage � Handling (Only mail-in applications) $ 1. 50
4. TOTAI. PERIKIT FEE (add lines 1-3 above) $
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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 co�lete, true co ect.
Si nature of A licant: .� ,.--�-� � �� � � �/ �� S
g pp _ Date: �
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� DATE TIME ,/
CITY OF ORONO CALLED IN /-Z/�3
INSPECTION NOTICE SCHEDULED `�/i-Zf 9 3 �a�: �..�
PERMIT NO. -�,C-��� COMPLETED � �l
ADDRESS �� U �
OWNER_�,��,�,/�2tr� CONTR. C�-c��� �
TELEPHONE NO. '�7 3 ���C� 3
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HO - O6 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
? 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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� I� CORRECT WORK&PROCEED �= ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVER�NG PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR - CITATION ISSUED
C7 INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
Owner/Contr te:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice