HomeMy WebLinkAbout2003-P06510 - sewer connect �. PERMIT
CITY C'�F ORONO
2750 Kelley_Parkway - PO Box 66 Permit Number: Po6sio
Crystdl Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued: ���i2oo3
SITE ADDRESS: 1980 Heritage Dr
Wayzata,MN 55391
P I D: 10-117-23-42-0006
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:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: �'�'idmer Inc. OWNER: Mr. &Mrs.Dayton
Box 219 1980 Heritage Dr
St. Boni,MN 55375 Wayzata MN 55391
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.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
(Updated 6/2/03)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay,MN 55323
GENERAI.INFORMATION
1. You may apply for utility pernuts by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Pemut cards will be sent by retum 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 pemut card is available on the job site.
5. Utility connection pemuts may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for urility stub as-built locarions. 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.
JOB SITE ADDRESS: ,��v ����/�`��- ��-��—
Occupancy Type: �_ Residential Commercial
Owner's Name: �;,�i�c ���i°��'J Phone Number:
Mailing Address: /S'f'o f��-�-t�f�� ��..v� City: Oru-�� Zip:
Contractor's Name: �'�'c��� �'�c Phone Number:
Mailing Address: �'� �o��if' City: ��.t,�r�t;o�,�S- Zip: .5'.s:.��s�
PERI�IIT TYPE [�'Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2003 rate $1,275.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size�inches; materials'��l Schd 40 air tested; cast iron
Municipal Water Connection/DisconnectlRepair ($35.00 per stub) $
pipe size inches; material copper; other
WATER ME?ERS 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'
PER1�iIT 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) $
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work �� �trict
accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all stat�ments
made on this application are complete, true and correct.
Signature of Applicant: � �E���� Date: �:��`;'
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DARC!L.MOE
DARCI L.MOE ' NOTAiiY PUBUC•MINNESOTA
' � ` NOTAAY PUBIIC•MIMNESOTA ��.��,, My Commisslort Ezp'ras Jan.31,2005
��;7i,;:. �fy Cammission Expires.lan.31,2005
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DATE TIME
CITY OF ORONO CALLED IN -7-/G�-G�
INSPECTION NOTIC � SCHEDULED �7- �u3� , 6;
PERMIT NO. � COMPLETED "_L�� �'. b
ADDRESS ���� �-���� ��� Q�
OWNER CONTR. ��f����^-z-�
TELEPHONE N0. ,� �`�G� ��/ � S�
� DESCRIPTION �e"�� � I��d� v�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL ,�WER HOOK- 06 PROGRESS
� 07 DEMO-SITE 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 FOUNDATIOWREMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO 1
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CTORY:PROCEED �gROJECT COMPLETE
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� ❑CORRECT WORK 8 PROCEED l❑SUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cal1 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector. �' "' `F'�"-� � n��
White Copyllnspector's File Canary Copy/SHe Notice