HomeMy WebLinkAbout2004-P07855 - sewer connect PERMIT
C I�TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Po�sss
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: s�is�2oo4
SITE ADDRESS: 2695 Kelly Ave
Excelsior,MN55331
P 1 D: 20-117-23-14-0008
DESCRIPTION:
Proposed Use:
Pernut Class: General
Pernut Type: Sewer and Water Permit Pernut Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
SAC Grandfathered In
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Thompson Plumbing OWNER: Charles&Roseanne Simpson
I5001 Minnetonka Ind. Rd. 2695 Kelly Ave
Minnetonka,MN 55345 Excelsior,MN 55331
THE UNDERSIGNEll 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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A � LI AN P ITEE S[GN ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reoorts, 1-Assessin�, 1-Finance Page 1
Doc-A4-2�D1 12:44pm Fram-CITY OF ORONO +�6Y24o4616 T-2�T P.001/001 F-306
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CITY OF ORONO APPLICATION FQR iJTILITY PERMTTS
Bax 66(2750 Kalley Parkway) SEWEIt/WATER
Crysta!Bay,M1Y SS�23
�ENER,� INFORMA'�YON
1. Ycu may apply for utility permits by mail or u:persan at the City offices.
2, Mailed in applications are subject to the postage and handlin�fee showa below. Perrnit cards wilt be sent by
return mail tha same day the application is recc;ived.
3. Permits are not valid until yon reoeive a permit card.
4. Work must nat begin unless tt�e pernut cerd�a available on the job site,
5. Utility connection perraits may be issued to licensed contrt�ctors only.
6, Coatact the Public Works Deparhneat (95?-249-4600) for utility stub as-bvilt locations. DQ NQT
EXCAVAT'E IN ANY STREE'T AND DO NGT TAP ANY MA1N without express approval of the Public
Work's Departmani. [ssunnce of a pemtit does not�ant this approval.
7. All we�k muai ba done in accnrdance with Stai o Code requircmeats.
, 8. AII work mtist be iaspocted before it is coveral. CaII(452)�49-4600.
24 hour notice reqaired.
Joa sr�����ss:�(�G� " ,
Qcraip�acy'I�pe� � Residential � Commercial
Ovraer's N�t: �`l m�:��.� � � � Phone Numbcr:
Mailtn�Addre��:�l��t -{��k�c. i.v-� � Cit���:��,-��
Contractor'a Naip - Phoae Nuaeber:�� -� - - ' �
Mailing Addrtss:'l--�-,1 .-�,��, ` City: 5�.�,,.. T�p:, �-,�
P�RtVIYT TYP�
Municipal Sewer Connection (�35.QQ per stub) $
1/���� pipe size�'_inches; m�terial,�Schcdule 40 e,ir tested; cast iron
''�""�' SAC Charge(2400 rate$1�150.00)must acconip�ny all stwer ptscnit applications unless pnepaid.
�+ �S If not grepaid,a sewer connectian permit will�wt be issued.
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1Vtuntcipal'1�Ater Connection($35.00 per stub) , $
pipc aiu inah ; matcrial _,,,.copger; other
WATER METERS m t picked up and pai�i for at City Ha11.
Water meters muat be ct s�n� sealed by (Irono Water Department (9S�-?A9-4600) ugon
compleHon of ineter tai t�on.
REQL�.Ia nim satbacks from drain�ield and segtic tanks=75'
REQCJ setback$ sewer line=�Q'
P�R��'F�FE�AL��L�iTL4�t
1. Subtotal of above perm,it requestcd $ ?��_,��� _
2. Statc.Surc�e $ .�0
Tha Stato Building Codc Divisinn Surch�rgn o�'$.SU per permit must ba
iaoladed for eacah well,sewer and water eounec:tio�permit rcquested.
3. Postage.8��Samdling(Orily mail-in applications) � �
4. TOTA.L PERMIT FEE(add lines 1-3 above) $ .�ti,.�;
The u�ndersigned hcreby appIics to the Ciry of�lrono for issuauct af a Utility Pernut,agrccs to do
�11 worlc in StriCi �icxordmxce with thc ordinan�:cs of the Cifiy and the regulations of th� State of
Muuicsota�and certi�ies that all statemcnts made on this�application are eomplete,true ar�d coaect.
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Signature of Applicant` I �U�,� .l'�(�-r-�,c, Date� �-��.--cx.__�,_
QD�A�T/E ��cf� TIME V
CITY OF ORONO CALLED IN �/
INSPECTION NOT E, SCHEDULED r���O`� �'rUt�P�'(
PERMIT N0. � �� COMPLETED �-'w—v4 I ',o(�
ADDRESS ��'C� � �-P���d •��
OWNER CONTR. I,�G'?�'�-S 6�� �Iu��--Z
TELEPHONE NO. ��� ��� � �� �
� DESCRIPTION
LL 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 -UP 17 SITE INSPECTION
Q OS FINAL 14 SEWE$�HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 GEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�YES_NO
� COMMENTS: I U�� 4t� fc\ �-1 C.�
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� ❑WORKSATISFACTORY:PROCEED ��OJECTCOMPLETE
W ❑CORRECT WORK&PROCEED �'" r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-460�
OwnerlContr to�e:
Inspector.
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