HomeMy WebLinkAbout2003-P06374 - sewer connection PERMIT
C I�'i Y�F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P06374
Crystal Bay, Minnesota 55323 Per'mit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 6iz�2oo3
SITE ADDRESS: 1160 Garden Court
Mound,MN 55364
PID: 07-117-23-24-0049
DESCRIPTION:
Proposed Use: Residential
Pernut 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: PermitFee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Metro General Services,Inc. OWNER:
5790 Quam Ave Northeast
St.Michael,MN 55376
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERM[TE GNATUREJ ; ISSUED BYSIGNATURE `
Copies: 1-File(SiQnitures Required). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
(Updated 6/2/03)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 6�5 (2750 Kelley Parkway) SEWER/WATER& SAC
Crysfal Bay, MN 55323
GENERAI.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 pernut card is available on the job site.
5. Utility connecrion pernuts may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locarions. DO NOT EXCAVATE IN ANY STREET AND
DO NOT TAP ANY MAIN without express approval of the Public Works Deparhnent. Issuance of a pernut does not gzant 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: _ �� (v D �/`3� cY P.� ��
Occupancy Type• Residential Commercial
Owner's Name: � � �. �� �� 'T'� Phone Number:
Mailing Address: City: Zip:
Contractor's Name: /1'l�0 ���,•►r�./�:SPr�/��,,,� Phone Number: ,�,�' �-�-�.-j�,�•�
Mailing Address: S'�9b Qu.t��r-t ��.--L City: t , � Zip: .�"s�'7�
PERMIT TYPE �Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,275.00) $ (Set Rate) �a�.3U�
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
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Municipal Sewer onnection/Disconnect/Re� ' 00 per s ., $ ���
pipe size « inches; material , Schd 40 r test ; c st iron
Municipal Water Connection/Disconnect/Repair ($35.00 per $
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 � ���
1. Subtotal of above permit requested $ � �
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage & Handlin�(Only mail-in applications) $ 1.50 (Mail In Only)
4. TOTAL PERMIT FEE (add lines 1-3 above) $ ,3.�" �
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work �r� �trict
accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all �tatear�ents
made on this application are com ete, true and corre ,. �
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Signature of Applicant: � .�"!,-.�� '�-a;�`r`'-�`�Y� Date: � ;��
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pAT TIME
CITY OF ORONO CALLED IN �P ���3
INSPECTION NOT E SCHEDULED O �l�
PERMIT NO. � COMPIETED
ADDRESS /(�° U '��/��� C'� �
OWNER CONTR. /4�'�fi'J7 C1�-�
TELEPHONE NO. ���ZQ - Z�.�
� DESCRIPTION ����' /' ��
� 01 FOOTING 11 MECHANICAL Fil 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WAIL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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 MEEi YOU�YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p 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) 249-4600
Owner/Contractor o ite:
Inspector.
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