HomeMy WebLinkAbout2006-P10447 -sewer connection �
PERMIT
�ITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PO Box 66 P10447
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 10/12/2006
SITE ADDRESS: 2995 7amestown Rd Unit#
Long Lake,MN 55356
PID: 2g-118-23-31-0004
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAI.FEE: $ 35.50
APPLICANT: Ritter Excavating OWNER: Mr. &Mrs.James Swanson
7120 Vernon Street 2995 Jamestown Rd
Rockford, MN 55373 Long Lake MN 55356
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 ORD]NANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE IGNATURE ]�SUED BY SIGNATURE
Copies: 1-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Scptic) Page 1
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• EOR CITY USE ONLY
��� City of Orono DateReceivedi . Permic#
O P.O.Box 66 ,
�"< 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
a� ���> �-��, Crystal.Bay,MN 55323 '
�+�'���`i�,�a�o� (952)249-4600 Approved By(If Required):
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CITY OF ORONO—SEWER&WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
ALL PERMITS- Nta be sub"ect to further review nnd ma not be issued�vhen thc a lication is recci ed)
GENERAL INFORNIATION _
1. You may apply for utility pennits by mail or in person at the City of�ces. I
2. Mailed in applicatioiis are subject to tlie postage and handling fee shown below. Pemut�cards will
be sent by rehirn mail within 2 busuiess days.
3. Permits are not valid until you receive a pernut card.
4. Work must not begin unless the peinut card is available on the job site.
5. Urility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locarions.
DO NOT EXCAVATE IN ANY STR.EET 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 iiispected before it is covered. Call(952)249-4600,24+hour notice required.
'< TYPE OF PERIVIIT; : ; .
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-: (Clieck All That�A .�,,,lY) ', ., ,
❑Residential(May Require Approval) ❑Commercial(Approval Required)
�-New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect
Job Site/ Owner Information: ' '
Site Address: ���������- ��
Owner:� t� ��.�/��- Mailing Address: Z�����
City: ��� ��� Zip: ���'J` �
Home Phone: �S Z �f 73��G� Alternate Phone:
Contractor Information:
Contractor���,,.< ����e�ontact Person: ��..��� ����-�
Address: ,/�� �'/�� State License#: f�� /
City: �t����� Zip:��3Expiration Date: �..z� ,�/ � � �.
Phone: 7C 3 ��7 �G �{� Alternate Phone: � /Z g/ � ��—f .,�e �
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❑ SAC Charge(2005 Rate=$1,550.00) �
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�Sewer Conne;ct}�n/Disconnect/Repair($35.00/Per Stub) $
Pipe size�mclies;material Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size uiches;material Schd 40 air tested; cop}�er
1. SUBTOTAL of Pernut Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In A�plicadons) $ 1.50
4. TOTAL PERMIT FEE(Add Liues 1-3 Above) $
� ` ADDITIONAL Il�FORIVIATION-'WATER 1VIETERS' ` ` '
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
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 regularions of the State of
Minnesota, and certifies that all statements made on this application are,true and conect.
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Applicant: Date: �0 ` ��i— � �
(�_� G�l L L /�, �G�J /] V
V ,pATE�� TIME
CITY OF ORONO CALLED IN �/ [
INSPECTION TI� SCHEDULED ��
PERMIT NO. (� COMPLETED
ADDRESS �g95 �A.✓k�A�'o'L� �
OWNER CONTR. �
TELEPHONE NO. �l a l I � `��o �i
� DESCRIPTION � � �� •
� 01 FOOTING 11 MECHANICAL RI 8 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/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 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC 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 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W��WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑ STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-4600
OwnerlContractor on si :
Inspector. ;� �� ,, �� �
White Copyllnspector's File Canary Copy/Site Notice