HomeMy WebLinkAbout2001-P04023 - sewer connection ITY OF ORONO PERMIT
�' ` Permit Number:
27�� P:�Iley Parkway - PO Box 66 P04023
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: ��2�2ooi
SITE ADDRESS: 3625 Eileen St
Maple Plain,MN 55359
PID: OS-117-23-21-0012
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
SAC Fee:
TOTAL FEE: $ 35.50
APPLICANT: Schluender Construction(See Comments) OWNER: Mr.&Mrs. Pidegon
3331 90th Street 3625 Eileen St
Monticello,MN 55362 Maple Plain MN 55359
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 BUIL ING CODE REQUIREMENTS.
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APPLICANTPERMITEESIGNATURE ISSU DBYSIGNATURE
Copies: 1-File(SiQnitures Reauired). 1-Avplicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
�U�J'.Ited 2�12�01�
CITY OF ORONO APPLICATION FOR UTILITY PERIVIITS
Fs�x 66 (2750 Kelley Parkway) SEWER/WATER
� Crystal Bay, MN 55323
GENERAL 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 handling fee 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 (952-249-4600) 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. Call(952)249-4600.
24 hour notice required.
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JOB SITE ADDRESS: `� f— / �-- �f'c`'��% S�� �� �
Occupancy Type: � Residential Commercial
Owner's Name: .J c;h-�J����P �� � �/ Phone Number:
Mailing Address: City: 7ip:
Contractor's Name: � �C l �4 r��-�-- C c n- i �. Phone Number: 7 E:�s'- 1 `�s^ S' �F� y
Mailing Address: �j �� �1��''= �7- City: /�c� '`��-��% Zip: �S 3E z
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) vuc $ --� S �
pipe size�_inches; material i� Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00) 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 (952-249-4600) upon
completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line= 20'
PERMIT FEE CALCULATION
l. 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. Posta�e& 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 th ordinances of the City and the regulations of the State of
Minnesota, and certifies that a 1 state nts made on this application are complete,true and correct.
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Signature of Applicant: 1, Date: 7 — � — v (
DATE TIME
CITY OF ORONO CALLED IN � � � ' f�
INSPECTION NO jC,E SCHEDULED ' �-3�
PERMIT N0. �/ ��� COMPLETED '� �"� �� • �
ADDRESS � �Z S � � /�� S�- •
OWNER CONTR. ��..�I�.t..Q.lx.�'t CdY�
TELEPHONE N0. ��'� � �-�S —���'�{
� DESCRIPTION �'���� ���'
� 01 FOOTING 11 MECHANICAL RI 18 EXCA`//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 OEMO-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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W �'CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �952� Z49-460�
OwnerlContracto site:
Inspector. �,'� -�f� ��C ����
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICF.� SCHEDULED
PERMIT NO. �
'r � ��COMPLETED �� � ' �C
ADDRESS_��•�� �i'��'-��t
OWNER CONTR.
TELEPHONE N0.
� DESCRIPTION ���k������—�� CJ�'JyiL�'I.
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD.
Z WATEF'iHQ�� 17 SITE INSPECTION
Q OS FINAL �14 SEWER HOQIS�IIP--�S O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��WORK SATISFACTORY:PROCEED ��OJECT COM PLEfE
W ❑CORRECT WORK&PROCEED � ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-4600
OwnerlCont , �on�e:
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Inspecto L `�1�
White Copylinspector's File Canary Copy/Site Notice