HomeMy WebLinkAbout2007-P11449 - sewer/water permit PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P11449
Crystal Lay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued:
9/17/2007
SITE ADDRESS: 2820 Farview La Unit#
Long Lake,MN 55356
P��� 04-117-23-34-0005
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pcrmit Sub-type(s): Sewer°,�"' `--"---������
Permit Type: Sewer and Water Permit c-------
DETAILS:
Approved perresolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Paid#4081 -09/07/1979
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Glenn&Rehbein Exc. Inc. OWNER: Thomas&Cheryl Howard
8651 Naples Street NE 2820 Farview La
Blaine,MN 55449 Long Lake MN 55356
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 PLRMITE SIGNATURE ISSUED BY SIGNATURF
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY � �j O� i
i'��� City of Orono Date Received: � ��
� �� `.i' Permit# G
�r��. �+. P.O.Box 66 G � �� I7J
�,�.,,,, 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
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1j'!'��.'. �� Crystal Bay,MN 55323
�``�+��k�'�`:,,��o�' (952)249-4600 Approved By(If Required):
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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 PERMITS- Mav be subiect to further review and mav not be issued when the aaalication is received)
GENER.AL 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 within 2 business days.
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.
TYPE OF PERMIT
(Check All That A 1
,�Zesidential(May Require Approval) � Commercial(Approval Required)
�New Connection ❑Additional Connection �Re-Connection �Repairs ❑Disconnect
Job Site/Owner Information:
Site Address: •�8� a ��'Y I �,W LC�-v1 e
Owner I/Yt�+-St,�SQ+'� ��� Mailing Address:
�ity: D r�n c� zip: 55323
Home Phone: c152'��--72(0-7 Alternate Phone:
Contractor Information:
Contractor: Glenn Rehbein Exc, Inc. Contact Person: John Carlisle
8651 Naples Street NE
Address: State License#: DO(ov'ZgF
City: Rlaine Zip:5544q Expiration Date: �2 � ��7
Phone: (612) 919-2019 Alternate Phone: (763) 784-0657
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'� ,'�• DETERMINING PERMIT FEES 4:
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� SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connectioo permit will not be issued)
� Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ 35•�
Pipe size l�inches;material$���1 Schd 40 air tested; 0 cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub� $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $ 35•OC�
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 35•S�
ADDITIONAL INFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate permit.
• 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 this application are,true and correct.
Applicant: 1�- /L , c���y. Date: ���71�7
Reset Form
��� DATE TIME
CITY OF ORONO CALLED IN —
INSPECTION NOTICE ' ( SCHEDULED ���,�
PERMIT NO.P I��`i'� COMPLETED �� �I
ADDRESS � �S�C� -�Q fr V 1 �� �N .
OWNER CONTR. ' � � �-
TELEPHONE NO. L —q � - I q
� DESCRIPTION ��C�J Yll(�C�
� 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
Z04 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 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO M OU: YES_NO
� COMMENTS:
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� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ CORRECT WORK 8 PROCEED '= ISSUE CEATIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. J PHOTO TAKEN
INSPECTOR W{LL RETIJRN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContracto on sit :
Inspecto�
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