HomeMy WebLinkAbout2002-P05798 - sewer/water connection � . �►.
CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Pos�9a
Crystal Bay, Minnesota 55323 Permit Type: Sewer and water Permit
(952) 249-4600 Date Issued: ii�i�2oo2
SITE ADDRESS: 3509 Ivy Pl
Wayzata,MN 55391
P I D: 20-117-23-43-0054
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Pernut Sub-type(s): Sewer&Water Connections
Permit Type: Sewer and Water Permit
DETAILS:
Approved per resolurion#:
Sepazate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL F'EE: $ 72.00
APPLICANT: Schulties Plumbing OWNER: Leisel Cox
1521 94th Lane NE 3509 Ivy Pl
Blaine,MN 55449 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'S 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 B GNATURE
Covies: 1-File(SiQnilures Required), 1-Atmlicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay,MN 55323
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GENERAL INFORMATION
1. You may apply for ufility permits by maii or in person at the City offices. •' � �
2. Mailed in applications aze subject to the postage and handling fee shown below. Permit�ards wil�.be sen�y'V
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 (952-249-4600) 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(952)249-4600.
24 ho r notice required.
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JOB SITE ADDRESS: � �
Occupancy Type: Reside Commercial
Owner's Name: Phone Number.�5'�-yv73��
Mailing Address: City•
Contractor's Name: Phone Number: ` �-
Mailing Address: City: � T� �
PERNIIT TYPE
Municipal Sewer C' pnnection ($35.00 per stub) $ ����
pipe size Y inches; material Schedule 40 air tested; cast iron
SAC Chazge(2000 rate$1,150.00)must accompany all sewer permit applications unless prepaid.
If not prepaid,a sewer connection permit will not be issued.
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Municipal Water Connection ($35.00 per stu $ ��
pipe size�inches; material copper; other
WATER METERS must be picked up and pai 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' ,
PERNIIT FEE CALCULATION
1. Subtotal of above permit requested $ ��•�
2. State Surchaz�2e $ .50
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
4. TOTAL PERMIT FEE(add lines 1-3 above) $ �
The undersigned hereby applies to the City of Orono for issuance of a Utility Pernut, 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 stateme ade on this application are complete,true and correct.
Signature of Applicant: Date: �� �� «�