HomeMy WebLinkAbout2002-P05125 - sewer connection �
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CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Pos12s
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued: s�i�2oo2
SITE ADDRESS: 568 Keene Ave
Wayzata,MN 55391
P I D: 02-117-23-31-0042
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: I
NOTICES/REMARKS:
I
FEE SUMMARY: Pernut Fee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Plaas Incorporated OWNER: Donald&7oanne Davidson
1427 Old West Main 568 Keene Ave.
Red Wing,MN 55066 Wayzata,MN 55391
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.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
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Apr-30-2002 0 :l0am From-CITY OF ORONO +g522494616 T- 34 P.004/00T F-474
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+ APPLICAT(ON FOR UTIY.I'rY'PERMiT
CI'TY OF OR NO SI;�g�µ�ATER
Box 66 (2750 K lley Parkway)
Crystal B�y, 55323
GENERAL INF ATIO
1. You may pply for utiliry permits by mail or in person at the Ciry offices.
2. Mailed in plications are subject to the postage atid handiing fee shown below. Pcrrnit cards will sent by return mail che same day
the applic�tion is receivad.
3, Permits a e aot valid antil yoa receive s permit csrd.
4, Work mu t not begin unless the permit card is available on rhe job site. �
5. Utiliry co ection permiu may be issued w licensed contrac:tors only.
6. Contacc e Public Works Depanment(952-249-4600)for utiliry stub as-built locations. DO NOT E CAVATE IN ANY SZ1tEET AND
DO NOT fiAP ANY MAIN v�+itl'►out express approval of the Public Works Deparnnenk Issuance of permit dces not grant tfnis approval.
7. All work ust be done in accordance witts State Code requiremenu.
g. Ali work I ast be inspectsd before it is covered. 2��(o�T»otice equired.
JOB SYTE A1 RESS: �6� �E� � Commercial
Occupancy T e: �Residential ��
Owner's N�m : 01�9 �1 v tfl � o^➢ Phone Number: 3 � S9- l��
MailingAddr ss: Z Za [.AeKo�� L N� o�.Th City: Pzy�u-�-� Zip: S �g7�,
Contractor's ame: PL AS 1Nc�i2.Po2.�"C'�-� _ PhoneNumber: 6S1 - �
Mailing Addr s: I 4 Z Z G Lp c.�s-r ►'�+q-�� _ City:.I'F-� w�u ta Zip: s o 6�
PERMIT TY F $ 5 O c�
Manicipal Se er Connection ($35.00 per stub)
pipe si�e�,^inches; material. i/Sck�edule 40 air tested; ast iron
SAC Charge( 002 rate$1,200.00)must accompany all sewer permit applications unless repaid. If not prepaid,a sewe�
connection pe 't will not be issued.
Mwnicipal V'V ter Connection($35.00 per stub) $
pipe si e inches; material coppNr; other
WATER ME RS must be�picked up and paid for at City HaIL
Water meter� must be set �nd sealed by Orono W$ter Department (952-249-460 ) upon complefion of inete;
installation. '
REQU D minimum setbacks from drain field and septic tanks= 75'
REQ D setback from sewer line=20'
pEItNII1'FE � CALCULATIO $
1. . Subto of above permit requested $ 5 �
2. State. urchar e
'Ihe Sta Building Code Division Surcharge of S_50 per��ermit must be
include for each well,sewer and water connection permlt requasted.
3. P sta &Handlin (Only mail-in applications) $ 1•
4. TOT PERMIT FEE(add lines 1-3 above) � 7• v
The undersi ed hereby applies to the City of Orono for issuance of a Utility Permi agrees to do all work in stri�
accordance th the ordinances of the City and the regulations of the State of Minnesot and certifies that all statemen
made on this pplication are completc, true and coaect.
Si�nature of pplicant: Da�' Z