HomeMy WebLinkAbout2006-P10497 - sewer connect PERMIT
CITY OF ORONO
275� Kelley Parkway- PO Box 66 Permit Number: p1o497
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
10/25/2006
SITE ADDRESS: 31351amestown Rd Unit#
Long Lake,MN 55356
PID: 2g_118-23-33-0016
DESCRIPTION:
Proposed Use: Residential
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
SAC Fee: $ 1,550.00
TOTAL FEE: $ 1,585.50
APPLICANT: Ritter Excavating OWNER: David&Stacey Royal
7120 Vernon Street 3135 Jamestown Rd
Rockford,MN 55373 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TNE 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.
i� , � /I � �� -
/`�'��� �� ' �i'� �� A/L-' �ii�--- l '�%��{ '�--"�
APPLICANT PERMITEE S[GNATURE ISSUED BY SIGNATURE
� Copies: 1-File(Sig�zatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
i
EOR CIT�USE ONLY�✓7C ��
��� City of Ot'ono Date Received: 1G'1ti • Permit# �/ � ,
P.O.Box 66
�� � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
a ������ �* Crystal Bay,MN 55323
'� � 4-` ti A roved B If Re uired
��q�,,��i��o (952)249-4G00 PP Y� 4 )�
'�$axa
CITY OF ORONO — S�WER & WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Ofticial and/or Public Works Department*)
(ALL PER�4ITS Niav be subicct to further review and m�v not bc issued�vhen thc anp��cation is reccived)
GENERAL INFORMATION
1. You may appiy for utility pennits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will
be sent by rehu�l 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. Utility connection pernuts may be issued to licensed conhactors only.
6. Contact the Public Works Department(952-249-4600) for urility shtb as-built locarions.
DO NOT EXCAVATE IN ANY STI2EET AND DO NOT TAP ANY MAIN���ithout express
approval of the Public Works Department. Issuance of a pemut does not grant this approval.
7. All work must be done in accordance with State Code requirements.
S. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required.
TYPE OF PERMIT
(Check All That APP1Y)
❑ Residential(May Require Approval) ❑ Conm�ercial(Approval Required)
�New Connection ❑Additional Connecrion ❑Re-Connection ❑ Repairs ❑Disconnect
Job Site/ O�vner Information:
Site Address: �� �� ��yKz�<zG'" %�='"�
� �
Owner:�j a^'�� ✓��� „����` Mailing Address: �� ,��`��-a����-- ���
`% � ���5 L�
City: �� ,�%— Zip:
✓
Home Phone:��2 'Gf 7� c��,�� Altemate Phone:
Contractor Information:
�� ��
Contractor:�.�/�:�,��,��ti��c'.��=�'�ontact Person: � %✓�`'v`���L
Address: 7���'1���� �� State License #: 1`� � �
City: ����a''�'� Z:p: S 5�7�xpiration Date: �� � �� " ` � �`
' 7 G �- (s /� - �%/ f — /�,��� �
Phone: � � � � � � s �f t Alternate Phoile:
� ,:, . ,. . .: .... �
, . � j ; , , fi ,,'''� ' D�TERMININ.,C���RMIT;;FEBS� '` ��` ' .�.:; ' r' f`§;r a,;
?, -
�AC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pemut applications unless prepaid)
(Orouo City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�wer Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inclles;material Sclid 40 au tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size uiches;material Schd 40 air tested; copper
1. SUBTOTAL of Perniit Requested: $
2. STATE SURCHA.RGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applicadons) $ 1.50
4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) $
' ADDITIONAL Ii�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 sh ict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all stateinents made on this ap�lication are,true and correct.
�? - r
Applicant; �./-��� Date: ,� " Z f - d�
� I � � I I l � DATE � �TIME
CITY OF ORONO CALLED IN � - v�
INSPECTION NO�TJ,CE I.��.J '] SCHEDULED JC�r�6-a6 (� U�
PERMIT NO. 0`"� 0 / ! / COMPLETED �✓" 'f� ��' �� S�'�
ADDRESS ��35 ����s �c.�►,-, ��,�_
OWNER CONTR. ,���� � ����-��
TELEPHONE NO. �� a ���/ � `��O a
� DESCRIPTION � S�'�„�-�.,r .�vv1c_._ i�}�
ly� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 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 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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
o � �G �S.� .� ,�T TP S7 � ►J
� t=- l � l�
0
�
W
�
Q
�
Z
W
�
W
�
j
GW�WORK SATISFACTORY:PROCEED [l PROJECT COMPLETE
� CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
OwnerlContractor on site:
Inspector. T/ /J �J
White Copylinspector's File Canary Copy/Site Notice