HomeMy WebLinkAbout2006-P09814 - sewer/water connection PERMIT
CITY OF ORONO
�2750 Kelley Parkway- PO Box 66 Permit Number: P09814
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued:
5/1/2006
SITE ADDRESS: 2175 Kenwood Way Unit#
Wayzata,MN 55391
PID: 17-117-23-41-0035
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connecrions
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Westonka Sewer&Water OWNER: Diane Eiden-Anthony Thomas Homes
6501 Co. Rd 15 4100 Berkshire Lane
Mound,MN 55364 Plymouth,MN 55446
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 PE M[TEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
,
,
F'OR CITY USE ONLY
�p- City Of 01'Ono Date Received: Perniit# _
O� �vO �'•O.Box 66
�,,.4,� 2750 Kelley Parkway ❑In-House SAC Detern�ination Form Cumpleted
a� ��j�Fu;��: ��* Crystal Bay,MN 55323 A roved B If Re uired
� 'T�,���,�.�o (952)249-4600 PP Y� 4 )� —
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CITY OF ORONO -SEWER & WATER/ GENERAL PERMIT
(*Note:Some pern�its may require approval by the Building Official and/or Public Works Departmert*)
(ALI PFR�'IITS- Mav be subiect to further review and ma��not be issued when the ann��cation is received)
GENERAL 1NFORMATION I
1. You may apply for utility pennits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will
be sent by reriun mail within 2 business days.
3. Permits are not valid until you receive a permit card.
4. Work inust not begin unless tl�e pernut card is available on the job site.
5. Utility comieetion permits may be issued to licensed conh-actors only.
6. Contact the Public Works Department(952-249-4600) for utility shib 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. Call(952)249-4600,24+liour notice required.
TYPE OF PERMIT
(Check All That Apply)
�Residential(May Require Approval) ❑ Commercial(Approval R_equired)
�ew Connection ❑ Additional Connection ❑ Re-Comlection ❑ Repairs ❑Disconnect
Job Site / Owner Information:
1 _.7 �� � �vc�1 (.,J c.
Srte Address: � �
Owner: .�v��h��� �c�����5 �(��.�Vlailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �.J�SC��+ �`' Contact Person: 15/'i1�� �[4�" �
/ ..—
Address: ���� CO . �J( (S State License #: � ����
City: (,�/l��"1 cJ Zip:S���� Expiration Date: �� - �S� �L�-�
Phone: � -2 ���-Z� S� Alternate Phone: �� �� ?��^S ��l
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DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�-Sewer Connection/Disconnect/Rep r($35.00/Per Stub) $
Pipe size � inches; material �Schd 40 air tested; cast iron
❑Water Connec�on/Disconnect/Re ir($35.00/Per Stub) $
Pipe size 1 inches; material�Schd 40 air tested;�copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
ADDITIONAL 1NFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all wark in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made o this application are, true and correct.
.
A licant: Date: � � C—�
PP
� DATE TIME �
CITY OF ORONO CALLED IN �
INSPECTION NO�CE SCHEDULED �-3-a�O ' G�
PERMIT NO. U�'1�Iy COMPLETED ,�_
ADDRESS :� � �S ,�l�-���'��CO ,C��=-I
OWNER CONTR.��S��I��
TELEPHONE NO. �' I� ��`�I �� 7`7
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. ATE HR OOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER H - 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC M NT. 21 COMPLAINT
� 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
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED L� ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �� pHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContract site:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice