HomeMy WebLinkAbout1999-011142 - sewer/water conn PERMIT
CIT�f bF ORONO PERMIT TYPE: _ . . . _ _
2750 Kelley Parkway- P.O. Box 66 `_��.'�'`.`� �r� !�'^ � �'`�
Crystal Bay, Minnesota 55323 Permit Number: _ .-
(612) 473-7357 Date Issued: �_ _- -.�-�
i; ; `-s�-
SITE ADDRESS:
-_.�% .':',�i�+_`,' .=� . .--
.�
... . . . . _:i--_ __" _._—f..—i:: :,,
DESCRIPTION:
__.: .__��i;tl,:°E� ::i-t;:�r:�
_��_`"__. . . . . . ..
� =s�� ' '`•t (:.`:i'�.t� ^ r•s T. ;` _ _ ' ��� :��;�-; �;�i
�-. --. ; .., �
' 4:'.. t _ .. 1 t'''�''s' i.'s ?_=:� `�•`'4._.�. �.:; :. �
-:�F.;�t' .;''� u1.��.�1' WF��:'t:. i yi��r I-ir`.-: i �,��r:li_...
REMARKS:
FEE SUMMARY:
�.. ���_j �..�i.� t.�...�
�:.�:=�= •�'� - • - -
-=�i ���i'`. . - ._._.._.._Y._� .�i..�
- -ai.�.s �"r''.'E_' .��•.:!_l�.�_1
CONTRACTOR: - ;:�=:�:� ; ,�:�-�+. - OWNER:
— —� .``i!'•,; t-`:...�.i� . . —•.�.�;`'_:�,�,:�� r:=�,;�i=st;`_? _ _�_f._.L:;::-c;'=�
��;.'.:' ;��' ='-i�_% _t-i __�`�!r t:,Y�?_; `i` #��.,.?;�
i. . -t;r`!;
Y_��.. . ... i,. . `t_.,, _ :: �.€t=,:�..,`a�_� •�f'u C'- ... _'}.
_ �� -
. . -._. f_�. ._.�i'.�._��4.-��U_'_. . ._.. .___.. . . ._. •'[%,'._.... . _. , ...�'".��'- - - _ _ �''� # �_. . . ��''�.�. . . .._ . ._.. ._. _.. . . ... . _... �... � c� .
_._.;.._�,_,_.�....:.- -:.:: - -- - ' - ' - - - �. _ .
�"ti��_; i ... � i.�{ .s�.i :�i�e�� _ i��{iYE i . , _. ... . ___�'4}`'�i_.a.. .. _ ?�S� i"5+._E....
.. :._.___", _, .
•_.. ;._��s = .i w_._ -'•.•.r . .'•_;�: : i �t :_ _ ;`�'._� .. _.. .. . i I`'? _ . . ._ _. ( i ;z: ' _. . . ...
,'_ii- ' ,_4 i �-._� i d. .. .!�=`. .r+Fv_1 _,t i;�;._ _.. ���_ :5 ._.._ _ . •:} .., _ .__......j! . _. t. __..._. . .... ,_ _ ._... _. _. .
L �
�
APPLICANUPERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PEP�11'IITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
� Crystal Bay, MN 55323 � �`�i�� ��
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 fees shown below. Permit 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 permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department (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 pernut 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. Ca11473-7357.
24 hour notice required.
JOB SITE ADDRESS: � � ` � C ��� �� `/ 1�.��.
Occupancy Type: ✓ Residential Commercial
Owner's Name: a��,' ;-�.-�_ `� �.,� �- ; `�, Phone Number: �,' ( L- �- i � �
Mailing Address: City: 7�p:
Contractor's Name: �t, .,' ; . :: � �*—�.=- Phone Number: '--��;= �, L;
Mailing Address: � :. � ��l 1�� �•� ��,� <2,. City: � �� :. ,,�� , 7�p: � � � ��
- �—)
PERMIT TYPE
i�lunicipal Sewer Connection ($35.00 per stub) $
pipe size�inches; material t'�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 4 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 pernut must be
included for each well,sewer and water connection pernut 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.
�
���� -� .�, .�r
Signature of Applicant: ��`vv{/)�. �'� Date: ^ i
DAT � TIME
CITY OF ORONO CALLED IN �°,�,���q � �O�``
INSPECTION NOTIC�E\ SCHEDULED � - a '`�� /C7 %3�n-,
PERMIT NO. ��`�f�"' COMPLETED �e� �_ 1
ADDRESS o� L�Q--
OWNER�� CONTR.
TELEPHONE NO. �� a- a 3�c�
� DESCRIPTION _ L.�JC��
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
�
O 03 INSULATION 24/25 WOOD BURNE IREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE iNSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c��, COMMENTS:
W , L
a T'ff711A.Se
J �/
O
� �
�
° ° '� e,r~ 2 S
W -
�
Q
z b ��-b �
� � `
W
�
� /
� �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMP
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContractor o .
Inspector. �
VYhite Copyllnspector's File Canary CopylSite Notice
�
DATE TIME
CITY OF ORONO CALLED IN ��:� 9, �a
INSPECTION N TICE SCHEDULED �s�/-�� _L�8
PERMIT NO. � COMPLETED
ADDRESS
r
OWNER CONTR.
TELEPHONE NO.7 0� 9���
� DESCRIPTION
C
� 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 HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP � 06 PROGRESS
� 07 DEMO-SITE ��+5??! � . 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALI. 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
Z
� COMMENT :
� �
4 r r 4
�
J
� l� �h. ��
O
�
W
�
Q
�
2
W
�
W
�
�
d �ORKSATISFACTORY:PROCEED ROJECTCOMPLETE
� ��CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
Owner/Contractqr�gn�it�:
Inspector. � U
White Copyllnspector's Fi e Canary CopylSite Notice