HomeMy WebLinkAbout2006-P10449 - sewer connect' PERMIT
G:TY UF ORONO
� I 2750 Kelley Parkway- PO Box 66 Permit Number: p10449
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
10/12/2006
SITE ADDRESS: 3175 Jamestown Rd Unit#
Long Lake,MN 55356
PID: 28-118-23-33-0014
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: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Ritter Excavaring OWNER: Scott&Melissa Ostendorf
7120 Vernon Street 3175 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 ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�/ �
��-�ic..,�.-e- �!��zZ- �
�
APPLICANT PERMITEE SIGNATURE [SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� '
• . � ,
� � �
• FOR CITY,USE ONLY�
,��� City of Orono Date Received Permit#
O P.O.Box 6G ,
���,i 2750 Kelley Parkway ❑In House SAC Determination Form Completed
a� ���.� � Crystal Bay,MN 55323
��� �i;�o�a (452)249-4G00 Approved By(If Required):
��R08
CIT�' OF ORONO—S�WER&WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Offcial and/or Public Works Department*)
(ALL PERMITS- Niav be subiect to further review and mav not be issued when thc aonlicntion is received)
GENERAL INFORivIATION '
1. You may apply 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. Pernut cards will
be sent by reftuzi mail within 2 business days.
3. Permits are not valid until you receive a pernut card. .
4. Work must not begin unless the pernut card is available ou the job site.
5. Utility comiection pernuts may be issued to licensed coniractors only.
6. Contact the Public Works Department(952-249-4600)for urility shib 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 inust be iiispected before it is covered. Call(952)249-4600,24+hour notice required.
TYPE QF PERMZT' ,.
(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: l d��
Owner. ' iling Address: �'� �• �"���
City: �� ;� Zip:
Honne Phone��z �{ 7� �4 �jr Alternate Phone: G �Z - G Lf I l/L-
Contractor Infvrmation: �
Contracto � ,.�c ntact Person: �G-LG�� �
����/.'�-�t � �`��.�
Address: �12C� `�/��rn �- State License#: � � �
City: �� �2-� Zip:�i�7�xpiration Date: 1� ' � f^ ��
Phone: 7�' /�Gf �� �G�j `� Alternate Phone: G� �Z cI � �'/ `4j�'
.
. , .
� � . . �.
! L j - �'� :7��i1 f " 4: 1 t:' t i� i} � -..
, `D�T�I2MININ.C���RMIT:FEES.' �;� ,,, � 5, ���
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can detercnine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
❑ Sewer Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inclies;material Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;inaterial Schd 40 au 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 L'uies 1-3 Above) $
',ADDITIONAL INFqORMATiON—WATER METERS"
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a s�arate 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 regulations of the State of
Minnesota, and certifies that all statements made on this application are,true and correct.
Applicant: � Date: �C� — �� �� G--
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOT C SCHEDULED
PERMIT NO. �y� COMPLETED �� __�-�
ADDRESS � I�I � J l� l�'�C�S'�`C��N
OWNER ������ �� CONTR._,� .�� �
TELEPHONE N0.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FR,4MING 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
Z
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO � ��/ f CS Ul_ION/REMOVAL
� COMMENTS:
W �� � �S ..i � � � i�" J`�-` �; f�
a , �
�
�
0
a
�
0
�
W
�
Q
�
z
w
�
W
�
�
d
W� �I(WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
�
W ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WlLL RETUFN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContractor on sit,e:
Inspector_ � �J 1�/ / /�
White Copyllnspector's File Canary CopylSite Notice