HomeMy WebLinkAbout2007-P11450 - sewer & water PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11450
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 24�-4600 Date Issued:
9/17/2007
SITE ADDRESS: 3067 Farview La Unit#
Long Lake,MN 55356
PID: 04-117-23-33-0007
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: Pernut Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Glenn Rehbein Exc. Inc. OWNER: Jon&Diane Rappaport
8651 Naples Street NE 3067 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 W1TH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PBRMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SignaruresRequired), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CTTY uSE ONLY I I ^
, � `' Cit of Orono Date Received:�1 Permit# C
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p� P.O.Box 66 ���
A•,,,,;. 2750 Kelley Pazkway ❑In-House SAC Determination Form Completed �{ � I�Q
i,;�y }�1'�� '. +.� Crystal Bay,MN 55323 D
�,���r�Y�`o� (952)249-4600 Approved By(If Required): ry,l/�'1
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CITY OF ORONO-SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Offcial and/or Public Works Department*)
(.�LL PERMITS- Mav be subiect to further review and mav not be issued when the application is received)
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 within 2 business days.
3. Permits are oot 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(952-249-4600)for utility stub as-built locations.
DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without egpress
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
,�,�esidential(May Require Approval) �Commercial(Approval Required)
�New Connection ❑Additional Connection �Re-Connection �Repairs ❑Disconnect
Job Site/Owner Information:
Site Address: 3C�b"7 �Gt-li'v(�,�J L-��
Owner:��✓�+�t olrr�Q F��'� Mailing Address:
city: (7f On l� zip: �S�3 2�_
Home Phone:�SZ-�I�J(o -�,� 8q Alternate Phone:
Contractor Information:
Contractor: Glenn Rehbein Exc, Inc. ContactPerson: John Carlisle
8651 Naples Street NE
Address: State License#: 0��8�
City: u�a;,,A Zip:5544q Expiration Date: �2 3� Z�d�
Phone: (612) 919-2019 Alternate Phone: (763) 784-0657
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� DETERMININGPERMITFEESi .�3s.�.,,�� :_�; ,�,�.,�;;
�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 connection permit will not be issued)
� Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ �.OO
Pi e size �'�� inches•materialSJ'�Q�► Schd 40 air tested• �
p 'y , , cast iron
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❑Water Connection/Disconnect/Repair($35.00/Per Stub� $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $ 35�C�
2. STAT'E 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 se�arate 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:���/C� Date: 1 I7 D�
Reset Form
9DA TIME ✓
CITY OF ORONO CALLED IN ` �
INSPECTION N sCE �f� SCHEDULED �7� ,7 D�
PERMIT NO. " ���`� COMPLETED
ADDRESS 3D�p7 �GZJ� Lr�.
OWNER CONTR. /���-'�e� �JC �-.
TELEPHONE NO. ��a g�n7 "2O�9
� DESCRIPTION 1��� ��7�/��
� O1 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 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 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTtC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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O G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR '� CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContrac ite:
Inspector.
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