HomeMy WebLinkAbout2001-P03810 - Sewer Repair { 3
PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Po3sio
Crystal Bay, Minnesota 55323 Pet'mit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: s�is�2ooi
SITE ADDRESS: 1255 Dickenson St
WAYZATA,MN 55391
P ID: 02-117-23-31-0027
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,500.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Roto Rooter Services Co. OWNER: MARION J DETTLOFF
14530 27th Ave.N. 1255 DICKENSON ST
Minneapolis,MN 55447 WAYZATA MN 55391
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WTTH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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A PL ANT PERMI EE I NATUR� ISSUED BY SIGNATiJRE
Copies: City,Applicant,Assessor,Finance Page 1
1 �
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for utility permits 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
return mail the same day the application is received.
3. Permits are not valid untii you receive a permit card.
4. Work must not begin unless the permit cazd 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 hour notice required.
JOB SITE ADDRESS: �b��n,L K.�.5���;
Occupancy Type: Residential Commercial
Owner's Name:_ �/1-l�c�, ,,, ,,,� ���-�r�-�-T— Phone Number: gSJ�- �����' �� 3 �J
Mailing Address: �a S �f�U'.�,,,,y, �i'f- City: ��v✓� u 7�: S 5�� �
Contractor's Name: I �� - �C�v�4� Phone Number: 7L 5 -- ,5��'-'S 9d�'
Mailing Address: /�S�D c�`��- Y}1k L'lJ City: p� � ,7�p:s�
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge (2000 rate $1,150.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid 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'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .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 & Handling(Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE(add lines 1-3 above) $
The undersigned hereby applies to the City of Orono far 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 st e ents made on this application are complete,true and correct.
Signature of Applicant: ��� � Date: -� �< J �/
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CITY OF ORONO � CALLED Irv� , � �S G I
INSPECTION NOTj�� E .� SCHEDULED l
PERMIT NO. /"v �c��� COMPLETED '� - �
ADDRESS /`��� 'C' 1�'� � .
OWNER CONTR. ��� ��'�"�f�--
TELEPHONE NO. �� 3 �' �CO 7 � �� � /
� DESCRIPTION ��-`-`E-�� �-e-1� �-�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d �UWORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
�l Ci CORRECT WORK 8 PROCEED C- ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL INSPECTOR �r CITATION ISSUED
fJ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
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Inspector_ �12-�-(/I�
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