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Home My WebLink About2003-P06834 - sewer connect � ' PERMIT C I TY O F O RO N O Permit Nu mber: 2750 Kelley Parkway - PO Box 66 Po6g3a Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit (952) 249-4600 Date Issued: 9�29�2003 � SITE ADDRESS: 4125 Highwood Rd Mound,MN 55364 P I D: 07-117-23-44-0084 '� DESCRIPTION: Proposed Use: Residential Pernut Class: General Pernut Type: Sewer and Water Permit Pernut Sub-type(s): Sewer Connection DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: �'�'estonka Water&Sewer OWNER: John&Roberta Henrich 6501 County Rd 15 4125 Highwood Rd Mound,MN 55364 Mound MN 55364 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. APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 (Updated 6/2/03) CITY�F 04ZON0 APPLICATION FOR UTILITY PERMITS Box 66 (2750 Kelley Parkway) SE`VER/WATER& SAC �rystal Bay, MN 55323 �.iENERAL INFORMATION �. You may apply for urility pernuts by mail or in person at the City offices. '. Mailed in applications are subject to the postage and handlinJ fee show�n below. Permit cards wili be sent by return mail the same day the application is received. �. Permits are not valid until you receive a permit card. !. Work must not begin unless the pernut card is available on the job site. �. Utility connection permits may be issued to licensed contractors only. ' 6. Contact the Public Works Department(952-249-4600)for uti?ity stub as-built locations. DO NOT EXCA`'ATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public�%orks Department. Issuance of a permit does not gzant this approval. ' 7. All work must be done in accordance with State Code requirements. ' �. All work must be inspected before it is covered. Call(952)?-�9-4600, 24 hour notice required. ', JOB SITE ADDRESS: '�1 ��J I+r �i�ov� �'� ` ' Occupancy Type: � Residential Commercial '� Owner's Name: Phone Number: Mailing Address: City: Zip: I Contractor's Name: '�e<-�, l,/� � ' ..� Phone Number: ��S.?1 Y�..?- y9 � `% � Mailing Address: ��S o� l� . �� i�� Cit��:��h.,��-7r.1 Zip:� S"�� PERMIT TYPE �Connections ❑Repairs ❑Disconnect (Check One) �C Charge (2003 rate $1,275.00) $ (Set Rate) ..� Charge must accompany all sewer permit applications unless prepaid. �Lf not prepaid, a sewer connection will not be issued) Municipal Sewer �onnection/Disconnect/ pair ($35.00 per stub) $ pipe size � inches; material �Schd 40 air tested; cast iron Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $ pipe size inches; material copper; other �;'ATER METERS must be picked up and paid for at Cin�Hall. �Vater 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' PERNIIT FEE CALCULATION 1. Subtotal of above permit requested $ 2. State Surchar�e $ .50 (Minimum) The State Building Code Division Surcharge of$.50 per pernut must be included for each well,sewer and water connection pernvt 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 in strict accordance with the ardinances of the City and t t�egulations of the State of Minnesota, and certifies that all statements made on this application are complete, true co ect. C � Cni Signature of Applicant: �� Date: � � � �� DATE TIME ✓ CITY OF ORONO CALLED IN 9-29 INSPECTION N TICE SCHEDULED �O-I-c�3 %°r o c� PERMIT NO. �D h8 �� COMPLETED ADDRESS ��ZS �.��`-�� OWNER CONTR. �.�-�S7FD11� �`�'�-� TELEPHONE NO. �,�i 2� �7 Z � �9.�� DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILUNG Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 iNSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPIAINT v 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 9�LUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO ME YOU:_YES_� ti COMMENTS: ` � a � j 0 � , �`v` 0 � W � Q � 2 W � W � � � � �NORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE W �CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERINCa PERMANENT ❑CORRECTUNSAFECONDITIONWITH�N HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.. Call forthe next inspection 24 hours in advance. (g52) 249-4600 OwnerlContra r it�: Inspector. White CopyMspector's File Canary CopylSNe Nofice