HomeMy WebLinkAbout2004-P07869 - water connect !
�
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po�s69
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued: s�23i2ooa
SITE ADDRESS: 269s xe11y a�e
Excel si or,MN 55 331
PID: 20-117-23-14-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Water Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 35.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Thompson Plumbing OWNER: Charles&Roseanne Simpson
15001 Minnetonka Ind. Rd. 2695 Kelly Ave
Minnetonka,MN 55345 Excelsior,MN 55331
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.
�
� r�'�°,G!� ✓'��=�� � , � r .L_-- �
�
APPLICANT PERMITEE SIGNAT RE ISSUED BY SIGNA URE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine. 1-Finance Page 1
�
D�c-04-2001 12:44pm Prom{ITY OF ORONO +D6224o4816 T-1oT P•001/001 F-306
�u�+uY��u�ia`�ui�
CITY OF ORONO APY'L�CATION FQR UITLTTY PER,NJITS
BoY 6d(2750 KeUoy Parlcwa�y) S�wER/wATER
Crystal Br�y,MN 5�323
[`R1�i2�1��I,iNFOS1N'�TU�N
t. You�naY aPR1Y for utilEty parmits by rnail or�:persan at the City afficos.
2, MaUed ia applicsti�s are aubjeci to the postage aaci Lanmiag fte shown below. Parnit cards will ba sea�t by
return mail tha same day tha application is recalved
3, Pecm[b ara not v�1W unttl you raoefve a potmit eard.
4, 'Wark must not be�in unloss�e permlt aerd�a svdlable an the job site.
S. Utiltty coanxdan permits inap�be iss�od to Uc�nsed camactors onty.
6, ContAct the Public Works Deparimeat (95?-249-�4600) for utt�ity stub as-bvilt lacaeions. DQ NQT
EXCAVA'!'E IN ANY STREEI'AND DO NGT TAP ANY MAIN wltl►out express approval of tha Pubiic
Works DepartmeW. Issuaace of a pera►it doas not @ant this opproval.
7. All w+xk muet be clone in accordenee.vith Stme Code requir�aea#s.
, 8. AA woslc must be i�speated betare it is covera l, Ca1I(952)349-4600.
TA hour aoUce req�tred.
aa8 sT�`T�AD�Es�:v���1S e�Qa�a re
p�q��'j�r�: ,� R.�sid�nti�t ll Commercial
Owuer'�N�a�i d.�� ' Phoae N�►b�r:
Ma�n�Adds�'�, — • Citptl��o Ti���� �
Contractar'aNu�pe: PhoucNumbe�:,��,-q_�
MsiIiung Address. ity:'M�c�c��d 7� �;5�4,5
P�12MYT'I'YPT
Munidpsel Sewer Conaectloa($35.00 per stub) $ •
11����4 pipe si�e inches; matcrial,,,,_,Schcdule 40 air tested; cast iron
�'� SAC Charge(200Q rate$1,150.Q0)muat acco�nzpaay all stwer pmmit applic�tions unlcss prepaid
�j � If not Frap�id,a sew�er co�.ectian permit will�wt be issued.
� Munlclpel'�itater Connection(�35.00 per stub) $ ���Ob
pipe aize�_inahes: mat�rial�'►,�.capper; other
WATER METERS mustt bc picla�d up and paii i for at Ci#y Ha11.
Water metera a�ast be set and seated by tlrnna Water Deparbmcnt (952-?A9-4600} apon
compledan of m�ter�ux#I1xtlon.
REQL7Y1��aunimum sctbacks from dr�in fiald and segtic tat�k.s=?5'
REQUYRE�ectbeck�rom saw�r line=20'
PF�I3lYx�'FEFr�ALCULATION
1. 9c�btotal of abovc permit raquc�tcd $ J��O
2. �tate.Surcl�arsx� $ .50
Tha State Building Codt Y7�ivta�on 3urcb�ga ai'�.SO per peamit must be
inaluded for eaah well,sewer aad water�onne��iou permit raquestuE.
3. Posc�ge.��aaaiinA(Oniy mail-in app�Ications) $_ �,i9- .
i
4. TQTA.L�PERMIT FEE(ndd linos 1-3 above} ��,
?he uadcrsi�aed her�by applies to thc City of�hona for issuaacc af a Utility Pern�it,agrccs to do
all work in striGt�cx,ordsute with the ordinan�:cs of the City and tht rtgulations of the Statc Qf
1Viinnesot�and certifias t1�at all stataments rnade on this'application ara eamplete,true and correct.
s��ofappt�G��.�izm����,�,�P�, n��: �-ao�
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED ��3'� =3� ,'�
PERMIT N0. �0�7�Lv9' COMPLETED
ADDRESS��g5 �� II�/ /7 C� �
OWNER CONTR. ,���1/N• ��CJrJ't �
TELEPHONE NO. CJJ v� g� � �J��
� 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
� 04 WALL BD. ��-VPRI'ER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENT�
c ' � �C`� S �
�
�
O
a
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d
W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHtN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance. (J52� 249-4600
OwnerlContra 't :
Inspector.
White Copylinspector's File Canary Copy/Site Notice