HomeMy WebLinkAbout1994-006501 - sewer connection PE MIT
CITY OF ORONO , ` '
PERMIT TYPE: _
2750 Kelley Parkway- P.O. Box 66 ;:�..����:.'� :�. ... . . :_.�;
Crystal Bay, Minnesota 55323 � Permit Number: -- -
::,,_'s_
(612)473-7357 ! Date Issued: ,.# .: _,,�
_ :<��� ; �DDR�SS:
,- °; -.�;—i;ri:' " , . .'
_ . . —E. f ' -- ..—:l.;.i.—'tt`...F•_",�_`.
�a� `�7:�,*-s'�'
; ��..� _ .�•.:. - - —i�.•
�:a:.s{ _'i�ui';:_:',`_. . �3_i1
,r::,�s _ — -;x13- �•i-,�;; .-;- r r i#r.l
'1 ... - ' -- -' -- .__3"4 _ _. �,?`k_�_ . _ _. .
_ _
��.,� ,
'�.:..� f�. ���;fi�
..1! ! L'! Lt!YVf�1:
.- r Av':l i'i �?ti+!'L
:.t71��1•L U! ! 1✓L
i.%ifuvv ir
: .....: :....:.:.... ;;. _ :, • r.. -_ ;-
!_1 i _i e c.�i _ Y f� A! L L }r!
._._.,�_.....�,...� SJJ. L'Li� �xlV
- - '� ' 'i{!!� 'r.'
. . . . . . _ �. . " _� . .. . ..�it�.{.'t�l:Vl• !7
"' "�'irt S'1
VS I.fLlf •✓L
�� .. _.
.�:L�1 !L alV
t.:L�i��'r_!?_ _'t S::iA!A� rft?1
.1LL:L1! ! !!!r7lT31 !L�L•
�VTRACTOR: OWNER: — �`z-�;�:F s.���=t:. —�
_ -..-.� . :.- . :-'�'-"'�`��'`�`= _':�;-:.��:,�<<_t�_, ^ ;.. . "'f��__�.i�=`
r
- . ". -.- ., .. . _�:��-;�::?��r�:'Ei,°�; r�°_:
�; 1,t=�;-�;,F�:;:� tt�. ;��_ .;;;
. . i��.i�_... _. . . .1.�� _ _ _ . _
�.'i-,: _._ :.1 i t_F"i�`_,.,
3 l.�7�L. . t�,�{4l.+tr�i�_ �^..3!k:F_:..1 !'���L�'� i'�=��i��ft�����_ ���i.'_i-'��?..._ ��!�.»;1�3� T3_.} �iC1F'-.� -t�!. �'.wf"��. .�.}��E���s;_�. '....? ��...�. . ,�
r�;�;{�r�:T rr� r�i��s ,'`_:;�'�F� -i!`� ',,�.E �•4 € ;�t�;:�:;F:: :r: ::;i"` �::� t.::� t � �' �t�€" � � 3 �1! ' :`�;��'`�: I���'
_ ��.._ :� �I :t�F'=_ F' �� �_ t� ,...�...
_S._�. i-]�lif✓ ��.,{�-E� j_��- �r:Y f�`.1��.f.�__! 4 :.. _ !���✓3 9\if,< ^'^iY t�,- �°�t�'j 1'�.. ..� :1,}`,j'_�e} .
. ... . . ... ... .... . . . .. . . L 1-.: . �
♦
� O l
APPLICANT- ERMITEE SIGNATURE ISSUED BY:SIGNATURE
l;l'1'Y Ul+' U1ZU1vU AYYL1l;A�1'1111V ��Ult U1'1L1'1'Y 1'I:KIVII'1'S
Box 66 (2750 Kelley Parkway) � a� SEWER/WATER
Crystal Bay, MN 55323 ��'(��
G�NERAL 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 fees 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 permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(473-7357)for utility stub 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 permit 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 473-7357.
24 hour notice required.
JOB SITE ADDRESS: � � ''°� � -���-�� �r�,
Occupancy Type: x Residenti�al Commercial
Owner's Name: i;, J; �-�
�,{: Phone Number: �-;;'� - ��-� `-
Mailing Address: �;, ,�v `���«�-��. f /��. City: ; -� ._ 7ip: ,�s�y s
Contractor's Name• ,�. , �" i i�=�PhoneNumber: �. : - �// `y
Mailing Address: j:�'`��o ,>-�na ��' - ,� City: � � _ . ,-.� 7ip. _;�(v�
�/ 's �'1�� 5�� `�"'''"Gt��� 4 �,�- ���''��
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) ; $
pipe size �� inches; material �� PVC (on sand fill); cast iron
SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department (473-7357) upon
completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta�e & Handlin� (Only mail-in applications) $ 1.50
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 in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application are complete, true and
correct.
'/� � /► ,��
. /� / � �� . ..
Signature of Applicant: � � � �� �• '
TE�- TI�,1E
CITY OF ORONO cA��E�iN ��`- ��y-Y`�
INSPECTION NOTICE scHEou�E� �U'l /; c'�
PERMIT NO. �s� � COMPLETED _�{ �_
ADDRESS ��� u��� � �
OWNER �� CONTR. � CL�1� � �
TELEPHONE NO. � y �'� ����'`
� DESCRIPTION
`L' Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FiLUNG
�
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z OS FINAL EWER HOOK-UO O6 PROGRESS
F" 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
�
Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PIUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
2
�+ 10 PLUMBING FINAL 36 FOUNOATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
w
4
� �� �
�
O
a
�
O
� �
�
�
Q
ti
Z
W
�
W
�
W ? ORKSATISFACTORY:PROCEED � �U�PROJECTCOMPLETE
� : CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
O ' Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
CORfiECT UNSAFE CONDITION WITHIN HOURS. ; pHOTO TAKEN
INSPECTOR WILL RETURN
STOP ORDER POSTED.CALL INSPECTOR
= CITATION ISSUED
INSPEGTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-73�J7
OwnerlContr ct on s t :
Inspector. �
White Copyllnspector's File Canary Copy/Site Notice