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2003-P06705 - sewer connect
PERMIT C I�TI�' �F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po6�os Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Perniit (952) 249-4600 Date Issued: s�29�2003 SITE ADDRESS: 1955 Heritage Dr Wayzata,MN 55391 PID: 10-117-23-13-0014 DESCRIPTION: Proposed Use: Residential Permit Class: General Pernut Type: Sewer and Water Pernut Pernut Sub-type(s): Sewer Connection DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: s�c vv ��/iy�19�3 FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: Charles Conner Plumbing OWNER: Todd Gorr 4220 Islemount Place 1955 Heritage Drive Robbinsdale,MN 55422 1955 Heritage Drive Wayzata,MN 55391 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. - ��'�'YL APPL[CANT PERMITEE SIGNATURE SUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 FROM : C,ConnerInc FAX N0. : 5357755 Aug. 25 2003 11:16AM P1 ��u¢-25-1�03 10�92am F�cn-CITY UF ORONC +Qp22464616 T-041 P�00;/001 F-60e �ITY b�ORON() �.'PL�CA�fY01v FOR UT�I(.YT'Y PC�9I'�� Bo:66 �2750 Kclley PszkwaY) S�WEIi1V1'�4T�R Ctyst�l B�y,1VTN 5532� G�L LN�01tM�4TiQN i. 'Y Qu may nDPly for ITti]itY Pe�uls�a by mail or iA person 0.0 tl�e City o�ices. 2, ��ed��pplirations a��nbjr,cc to the posr�e aad head�ing£ee ehown below. Permit cruds wiil i�ee sent by���o same da: tho spplication is roceiveui 3. P'armiCs sr�e not valfd unW you reeAlve a permit card. 4, Warlc ros�st nat begis ual�:ss the p�r�r+�t c�l is ava�labl��ibe Job site. � s_ C7dliry connerliion garmiss may be issned to liccased cona�cton oa1y. � 6. Gon3uct�ie Publie Wo�Dopertmo�ti(452-?h9-4b4E►)far utiu4'stn��e'b�«����ons.DO NOT BXCAV ATE IN ANY S'� A �O NOT TAP ANY MAYI�w�au��pa'�s�gPW°°�1 oEthe Pu.bLic Wo�cs Departzne�.Issuauce of a permit docs not granstlus a�praval 7. Alt work must be�vs�m sc,ecrrdance viritb Stsm Cade req�tiree�►a�. $. All work must be inspeatad baPora�is cwerod. Z4 b0u�r'aoC� arequired. � .� �nT - � �� � � _ JaB srrE�n�►�ss: � � ��upabcy Type: Re�ident��l J Commerdal m��,� c-r- � _ � F one Na�b r. y N�" Qwner'�Na�e; �,,���,� �a � Zip �� �ing aiddre31.9• ���D . �•� � � ` W m�g +Con�ctor'�Narn�: �hoac Nu�onber: m� MaiJiag Addreas:______ C��3'� ��� - �z�'�° �...zz� w�'�C ���� wo�3 Muafcipal S�rer C aaect�ida (�35.Q0 per slub) � a�om p i p�s i z c�inch�s; ma�nti�. ch�dule�ait�es�ed; cest i�an �m� SAC C�gg(2Qfl2 zaze$1,2�30.00)must acc�ompanp all sewcr pern�it applicatior�uatees prepaid. If nat grepai c��e connection penz�it will not b�issued. . . � �� �� Muniafpsl'Water Connee'tYon($35.D0�er swb} � pipe sizz.____�unc1�; alater'tal Gnpper; other Vi�'A'I'�R METERS nvust be•pi.ckrd up and p�id�nr at City Hsll. �aYex m$�pt� m�t be se# and sealed by Orouv W�4er Departmtat (952-249-�ff04� upon �omgletion oi �ete. YGB�IlaCiOA� REQUTI�D minimum setbacks from dtaix�field and septic tanics=75` �+.EQUIRED setback fram sewer lme=20� . PERMYT����� '�N 1. S�bLO'fS10f ab0've pe�mit reqllested � ,Sp 2, Scate SurcharE� - Thp gt�e 8uitdi�g Cod�Divisien Ssuchatoe arP$.SO per permi[must be tacluded for esch wall,sewer aud wr�oes coneeetian petntit reque�d 3. �i$ ee!�HsJ�d�e��uly m811-an appliaadars) $ 1�5Q �, � 4. TOTAL PERMl'T FF.E(a.dd iines f-3 above) � 'lhe vndersignr,d hereby ap��lies to the Ciry of Ckono for issuax�ea of a Utility i'e�.it, agrees to d4 all wark i� atric sccflr3sn�e wfth�the ord.inances of ilu C�ty�d th� atia�c�f the Statc of Ivi�rsn�c►ta,and certifie�tltat alI statament made ott�rkhis ag�liaation�te complot2,itue an � —a�'"'�''�'�\ � Signatr.ues of Applica�t: " Date; � � J �3 � ___ -- 7 -- - - -- CHARLES CONNER PLUMBING, INC. li0681NSDALE M�N;��ALCE FROM : C,ConnerInc FAX N0. : 5357755 Aug. 25 2003 11:17AM P2 UL/LU/GUUJ 1J:b,! .���,� � •,r, 55'd '.:':��� :�A'L7.UN,11, � CHUi;K H51 I�JUU1iUU.I. _.. . ------____..... --- •.--. ..---... �1�1.'1�'.::St��!t�::;••.�.�..'�'J._����f..._��-.�!•�����1-l.��L�..i.l���]J"_�L�:..? �. .... � .�±;�r� �t �t�-�����r� - � ����1'1��f�' ��;?�,"�.1?'1'��,� e�t ,�:����� ' '�' r G �rta•••� : , PLUMBI:NG lJNZT, �OX 6497 S � 1�1 }:.A,a'1' SF;VFU7�! FL3lt;B, �'P. PAUL� MN S 5 Y 6 4-0 97 5 � i�Ta��Px plctarbe� Licer�se � ` 9 !1:'�_?i_�; �a,r ��e�F:3_�:,�,��,i � �' Ch�r�es 8. c:vnnPr � 47?� Ts7,emo�snt Y1aCe Hobhi.x�si��Ie, Fg7 5�b�z- � er��t:rt.� oATE ExPrRAT1011 tiqTE 01101/��Z3 12/3]l206� : ' ..'— ' �� ..:�..�.. ..�. ��..".."" .::'1:i�FY'a. �W'�Vlo 1 �ITI�NESDTA DEPAR�I�ENT OF H�LTH BONOING A.N� TNSURANCE CERTIFICAT'c � i '�nis is to certi�y trat C�rarTes B. Conner, Mast�r �';,�ber License l�lj tio. PNDd5388, re,r,resentir�g �narles Conner Plurabers, In�, , has �fi �ed � �25,�04 �F bond with t�,e Secret�ry efi S�ate on t�'avember �5, 2G02 anu pr�vided ev�den�e �f �{ �i Puiyl�ic 1,�a511ity insura�ce, inci:�ding Products �.tab�l�ty Insurance o� at ieast :.I: lI s5Q.OG0 Rer pe�sc�� a�d SlD�.d�O per occurr�nce �nd Pr�oper�ty Ja�ag� [;�sur�ance � Q� 3+ �easi: �10.Cr�D �o� �E�e y�ar 2ap3 i n acc�rdance �h��th th� oraui s i o�� �f I �I �� � hlir;nQsa�a 5tatutes Sec.tion 326.40. Br,�td0 NO � � . R�Z 5s�7�9 POLrCY N0. Q0� 042�6y6� flC � �� i;. c:� ''�F�bl�; Sa���*�� Ce��nA:���y West �er�d I�lu�ual Insuran�e I . � ! !'es hlo�n2s. rowa Cawn Zimmer�an, ��ir�n�so�:a Agent � { Montic�llo, Minnesata I � NR CHqF tS 6 CONNER �---� � C/�rH�h�7RLE ' J' r Z r .'.,��( ,- .' , ,� _ � � _... � . `IGL� �� � ' vI1L.+ r _Jy .r � � a . . � l , .� �? ��.ri�_ ..� II �I ROSBI����ti�r. ���h � C1t741/ �� � Patricia A. Bloomgren, Dir��t�r� I�� Qi�`�si�n of Em�'rvr mieri�,a i ne��Lrr i � �� �1 4 Jan K. t�a'ico�►�. COfi�m15S�n�� � � �� . �� I � - � ._______-____ -- - �. -_-.._.._.. _. .�. _ � _ - _. ._._�___ _-_. . � . . . 3��w� j.��.� �.�. . .����.��� �--' r � E�#ifi i .., _;el�. r. �r��. 7�.��: `,r,i �d�,ncJ n ��(e;ip � . . . . � . �. �. . ... . . � � � � � s� � C� C� � E� � � _____----._____ �� _� � � � _ � — _ -= - �_ - Tax Map#10-117-23-13-0014 I Euqene&Sharon Clark Since Dec 1999 i 1955 Heritaqe Dr, Wayzeta ____.__ _. .__ FOXHILL 001 _.__ _ _____ ._ Euqene&Sharon Clark'1955 Heritaqe Dr;Wayzata MN 55391 � � � � ������