HomeMy WebLinkAbout1999-011161 - sewer/water disconnect PERMIT
C!TY OF ORONO PERMIT TYPE: _ _ _ __ _
� .. �750 Kelley Parkway- P.O. Box 66 -_ =' ... . . _-.
� Crystal Bay, Minnesota 55323 Permit Number: a�j_,i
(612)473-7357 Date Issued: - LL
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SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��"i�
CITY OF ORONO APPLICATION FOR UTILITY PEP�iyIITS
Bog 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323 ��� �-='f
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GEI`�ERAL 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 fees shown below. Pennit cards will be sent by
return mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Depar[ment(473-7357)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«-ork must be inspected before it is covered. Ca11473-7357.
24 hour notice required.
JOB SITE ADDRESS: ���`� �t�1..-�- {�.��-
Occupancy Type: � Residential Commercial
Owner's Name: Phone Number:
Mailing Address: Z�F� �-�Il-� ��-� City: c>v�.� ,,t-; 7ap:
Contractor's Name: c,w � � Phone Number: �3-2, �7 �i 7
Mailing Address: 1�=�:�� i w.k-►� - :1�.r�w�,5�c� �' �ty� Y'v�w��� , 7�p:S�3 �
ItMIT TYPE
,��� unicipal Sewer Connection ($35.00 per stub) $
�h`�`" pipe size inches; material Schedule 40 air tested; cast iron
SAC Charge ($1,050.00) 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.
(5/8" meters = $130.00; 3/4" meters = $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(473-7357) upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield 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 pemut 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 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 complete, true and correct.
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Si ature of A hcanf: � Date: 1 ' .
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DAT TIME
CITY OF ORONO CALLED IN /�'�`�_ 99 ••���''
INSPECTION NOTICE SCHEDULED "// � "P 9 i �
PERMIT NO. G����� � COMPLETED
ADDRESS o7 J�5 �'��""."",4- �'�-'
OWNER���- CONTR�'�"�°'�' ��'6�
TELEPHONE NO. �� -3-- 77/�
� DESCRIPTION _����%��- �' �'�'�' ���'�''`�''"`'�
� 01 FOOTING 11 MECHANICAL RI 18 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 i�96Rf�P 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-S�TE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAI 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContractor si��
Inspector. �V
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