HomeMy WebLinkAbout2007-P10783 - sewer/water connections - • � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o783
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
2/22/2007
SITE ADDRESS: 2340 Glendale Cove La Unit#
Long Lake,MN 55356
PID: 34-118-23-33-0062
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: Ouverson Excavating OWNER: Bohland Development
252 36th Street S.W. 1844 Wayzata Blvd.
Montrose,MN 55363 P.O. Box 815
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.
A L[CANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
POR CIT1'LiSG ONLY
" '` City of OCono Datc Rcceived: Pcrmit#
,_ O-_
�;�g ��� P.O.Bos 66
�%�,. �\�;� �7�0 t�elle}'Park��ay ❑In-EIouse SAC Detcnnination�orm Completcd
�� 1�:�'� ` ��� Crystal Bay,MN��323
�� ��,' ",r o`� (9�2)2a9-=1600 Approved Sy([f Required): �
��"'Kz^siao�`$>�
CITY OF ORONO— SCWER & WATE12/ G�NERAL PEI2MIT
(*\ote:Some pennits inay re�yuire approv�!by the I3uildin,Official and/or Public Works Department*)
(r�Lt.PI;Ri1I1"I�S- ��fav bc sublect to furthcr revicw and m;n'not be issuccl�vlien thc aPplic.ition ic recci��cd)
GTN�RAL 1NFORMA'1'ION
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 sho�-vn below. Permit cards will
� be sent b,y return mail wilhin�2 business days.
3. Permits arc not valid u�itil you receive� permit card.
4. �Vork must not be�,in unless the permit card is available on the iob site.
� 5. Utility connection permits may be issued to licei�sed contractors only. �
6. Coi�tact the P�iblic �Vorks De�artment(952-249-4600) for utility stub as-built locations.
DO NO"I' E�CAVATE IN Al�l'STRGE"I`AND DO N07'1'AP ANY NIA[N without express
� �ipprov�l of the Public�Vo►•Ics Deplrtmcnt. lssuance of a permit does not grant tliis appi-oval.
7. All �vorl:must bc done in accordance with State Code requirements.
� S. All worlc must be inspected before it is covered. Call(952)?49-�i600,24+hour notice requirecl.
TYPE OF PERNIIT
(Checl<�11 That Apply) �
�esidential (May Require Approval) � Commercial (Approval Requirecl)
�r�Connection I� Additional Coiulection � Re-Connection �� Repairs � Disconnect
Job Site/ Owner Info►-tnation:
Site Address: �.� �� �-� ��/1•� �
�
�
R
U��'llef: � Nlc�llllla ACICII'eSS:
City: ��� �i.��� : 7ip:
� Home I'IZo»e:��'�— �1�� ��'�� Alteri7ate Phoile:
I
C011il'aClOI' �I1t01'lllallOtl:
�
� C011tl'2CtOC�LL L��I�j-L �(_��� C011l�iCt �el'SOII: c�`l7
� \� �
Address:a��- �� � � -��-(J State L icense #: �� ,}��
Cit�-: � � 7_,ip��!",��piration Date: �'
Pllone:�lv�-- ���` ��� / Altei-t�ate Phone: ���,� �/ � �,���
DETERMINING PERMIT FEES
[� S:�C Charge(2007 Rate=51,67�.00) $
(SAC Charge tliust accompany all sewer permit applications unless prepaid)
(Orono City Staff cai�determiite if a�plicable)
(If not prepaid,a se�ver connection permit will not be issued)
❑� Sewer Connection/llisconnect/Repair(�35.00lPer Stub) �
Pipe size inches; material Schd 40 air tested; 0 cast iron
❑� ��'ater Connection/Disconnect/Repair(�35.00/Per Stub) �
Pipe size / _inches; material___Schd 40 air tested; 0 copper
l
l. SUBTOTAL oPPermit Requested: $
2. STATE SURCHARGE � ;0
3. POSTt\GE& HAI�DLING (Oniy on Ylail-In Applications) S 1.50
4. TOTAL PE�2M[T FGE(Add Lines 1-� Above) �
ADD[TIONAL INFORMATION - WATER MLTERS
■ �VA1'ER�IETERS must be pickcd up and paid for at Orono City Hall,these are on a se�arate permit.
� �V�T�R M�'TEAS m�st be set ancl se.�led by Orono Water Depa�•tment (9�2) 249-a600, upon
completion of ineter installation. •
The undersigned hereby applies to the City of Orono for issuance of a Utilit�� Permit, agrees to do
all work in sh�ict accordance with the ordinances of the City and the re�u(ations of the State of
Minnesota, and rtifies that all statements madc on this application are, true and correct.
Applicant: � l � �" ��i�`���"' I?��ir: _� �� �
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