HomeMy WebLinkAbout2004-P07628 - water connection � . �
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po�62g
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 6i22i2oo4
SITE ADDRESS: 1725 Fagerness Pt Rd
Wayzata,MN 55391
P I D: 17-117-23-22-0036
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Water 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: Atco Utility Services OWNER: Mr. &Mrs. Curtis Taets
3660 County Rd/ 101 S 1725 Fagerness Pt Rd
Minnetonka,MN 55391 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 PE 1TEE SIGNATURt: �[SSUED BY SIGNATURE
Conies: 1-File(SiQnitures Repuirect). 1-Annlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
(Updated 1/5/04)
CITYAF �,:.RONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for utility pernuts 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 pernut card is available on the job site.
5. Utility connection pernuts 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 ANl'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 hour notice required.
JOB SITE ADDRESS: �%�' �`���-''`�'-��� ��'�7 ✓'�/,I,
Occupancy Type: �_Residential Commercial
Owner's Name: �'.��� ;, f�%S Phone 1\umber: �s� ' ��/` d�7�
Mailing Address: /'7�5� ��; � N s ,,Ur R�l City: /,��Nn Zip: S s�-._3i/
Contractor's Name: �l� //;i��T✓ �5��'�����Phone \umber: 1 s��-- y73- i�y7
Mailing Address: ,�C��,� �. 2�. l�/ City: d'�'i�n%,��k.� Zip: SS3i'l
PERIVIIT TYPE �Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair (S35.00 per stub) $
pipe size inches; material Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair(S35.00 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 `Vater 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'
PERIVIIT FEE CALCULATION
l. Subtotal of above permit requested $
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well,sewer and water connection pernut requested.
3. Postage & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only)
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
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Signature of Applicant: �__ Date: o d
��'`— , DATE ,� TIME �
CITY OF ORONO CALLED IN � (v �
INSPECTION NOTIC SCHEDULED
PERMIT NO. �� ���� COMPLETED -��
ADDRESS l`7�� 7� � C�_!�'UL�"�' �'` ,C�l�
OWNER CONTR. �c��'v l.Cf-i/.
TELEPHONE NO. ��� � �� ���� �
� DESCRIPTION �� � �'�� •
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� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q03 INSULATION 24/25 /FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOf - �7 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 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENT :
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W� WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED '-' ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,_� pHOTOTAKEN
INSPECTOR WILL RETURN
'-� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-460�
OwnerlContr r o ite:
inspector.
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