HomeMy WebLinkAbout2006-P10030 - sewer/water connect PERMIT
C�TY OF ORONO
27;�0 Kelley Parkway- PO Box 66 Permit Number: p1003o
Crystai Bay, Minnesota 55323 Permit Type:
Sewer and Water Pernut
(952) 249-4600 Date Issued: 6/26/2006
SITE ADDRESS: 3565 Frederick St Unit#
Wayzata,MN 55391
P��� 20-117-23-12-0018
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Westonka Sewer&Water OWNER: Minnetonka Custom Homes,Inc.
6501 Co. Rd 15 6175 N Sinclair Rd.
Mound,MN 55364 Mound,MN 55364
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 REQUIR NTS.
�
C�— �-'<_;,�� � � �✓��' � ___--�-,`c"��'��
:� %✓,—!' /�'i,'
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�
FOR CITY USE ONLY
��� Clty of OCOno Date Received: Pern�it# __
O s Q P.O.Box 66
�,,.;�„ 2750 Kelley Parkway ❑In-House SAC Detem�ination Form Completed
a �;�r'' � Crystal Bay,MN 55323
'a ��?�j1�'ri�. a~ 952 249-4600 Approved By(If Required):
t T,.S .,;�w ( )
'�sea�e
CITY OF ORONO -SEWER & WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department")
(ALL PERNiITS- Mav be subiect to further review and mav not be issued when the aonlication is received)
GENERAL INFORMATION
1. You may apply for utility pennits 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. `Vork must not begin unless the pemut card is available on the job site.
5. Utility com�ection permits may be issued to licensed conri•actors only.
6. Contact the Public Works Department(952-249-4600)for utility shib 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 pernut 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 Apply)
,�Residential(May Require Approval) ❑ Commercial(Approval Required)
( �
�w Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑Disconnect
Job Site / Owner Information:
,
Site Address: ���� �E'��'�`c
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor:
���"1 � � C.-� Coiztact Person: l�1���->� L1�•'" �
/ �
Address: �� �U ��( �� State License #: ` ����
City: ���✓I,C� Zip:���ExpirationDate: �� 31�d
�
Phone: C�.�,l�f 7� "y`� � Alternate Phone: ��-� 7 �l ���
�
DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,550.00) $
(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)
�ewer Conn ct'on/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; cast iron
�ater Conne�tion/Disconnect/Repair(�35.00/Per Stub) $
Pipe size�inches; material Schd 40 air tested; copper
1. SUBTOTAL of Perinit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
ADDITIONAL 1NFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall, these are on a separate pernut.
■ 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 statement ad this application are, true and correct.
�
Applicant. Date: - � �/
� �� `7 ���c;�
DATE E
CITY OF ORONO cA�� o� � C� '��Lr vb � O._ ,
INSPECTION NO CE SCHEDULE�I� �� �'� ' ` �
PERMIT NO. �U ` COMPLETED �� j�f
ADDRESS .�_5�� �i".F''�Gl�� c:f C
OWNER CONTR. //��..�"�i ti��'
TELEPHONE NO. S � ' `l ` �I� �
� DESCRIPTION �`�� ����
�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 17 SITE INSPECTION
Q 05 FINAL � 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 AINT. 21 COMPLAINT
J 07 DEMO-FINA� 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:
� �
W
�
�
J
O �
�. �, �- t-,
� ��
° � S
w
�
Q
� �^�.r
Z �
W
�
W
�
j
GW �ORK SATISFACTORY:PROCEED f l PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,`, pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
G INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContr r site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice