HomeMy WebLinkAbout1997-009698 - sewer connect ' PERMIT
,
� �
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 � ��'
Crystal Bay, Minnesota 55323 Permit Number: `t`� ' . _
(612)473-7357 Date Issued: :��.=��:
SITE ADDRESS:
DESCRIPTION:
.. .•r,
�S �' — r:�-t
. � �- ...�...� T � •:„-.
.,.:�L:�.._e ._. .. _ .:5'.l� � .,. .._ . . , , .. . .._...._. . . ._�... . .., .
._ p' _. '. . . ..,_. {
��+.'.:`�1:� { .. �.�-l C_'7 1�. . . : ..'.�r..i �Y' _ .._.. . .._..
REMARKS:
FEE SUMMARY:
.: ....__
_ �. ,-
_ . �:,-� . _______ -
_. . �. _
, ..��:.._. : �.... . _ . _ _
CONTRACTOR: = OWNER:
_ .,
�i--�- f s�r'. � �'...�ix� � ',Y.� rr� a �"1�{,�,��"'","�.`r w .: i � -a� , �; ' _
. . .. " ' _
.
:`;�'�-.� ������t '�sr��,-� �.# .��.�,_ �f`s �,s� ��...�... }����°�y. ��'� ;wr�"�I�.."="f` �.�ti���.� 3�� �m!:��?"��? �-a�_�._{�
. .
,
,. ,
� � : ;.
. _ �_. . ...._ .�..� . .., . , � _ . . _
_� . . - ��'� ;��s� �•��t�t.�:�'�T� �' �..�����+ t.�...�:� �t�<:�}_�� .� � .�
�' � .t�'t ,4_.�I l��;a
� _ �
./�`-Ctti'`� L/C���'�
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� � '
% �;" 'a '�"�' '�: �'aF;�,�, ,�i..�i
t�a
�� 1r. CITY OF ORONO � APPLICATION FOR UTILITY PERMITS � �'� �'��;�
J Box 66 (2750 Kelley Parkway) SEWER/WATER ��
��� ��
` CrystalBay, MN 55323 _.�. . _ ��, h � ���.��� �ri�`���'����
GENERAL INFORMATION � � � �µ '� ���� �'�F
,; � �r" i�,-�
:� 't,, ,
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. �
�, =���-.`''�'� . ;a- ' � ��c
h` 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. ' '�j
��-� �
� �,,,' ', 6. Contact the Public Works Department(473-7357)for utility stub as-built locations. DO NOT EXCAVATE �',;��,� ;,f
�-n
� 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. ������t��
�..� �
� 7. All work must be done in accordance with State Code requirements. �+���'�x�
:`���� 8. All work must be inspected before it is covered. Ca11473-7357. �`��`� � � � ��� { k�s �`� �
�� �i ��
�` 24 hour notice required. �, �-.=' 3�,.��� �'
, � � �����
= l� ��:�� � .�
JOB SITE ADDRESS: �v � � -�'�'- '��'�'�'�- T ���
>�`_� .
Occupancy Type: Reside tial Commercial �t�
''�"x' Owner's Name: . � �' PhoneNumber: �� 7 ; � �� �f �� 7 ��
�t�—�—,��'�.�
�� � —
r,�� �� Mailin Address: � �' -�7-��"'-,=._t- `;,��-���-+�.Ci : �� ���-�'�l
F 1 ,., g h' �-��-a--*��- 7�p: J � � � , y;
Rr ;� � Contractor's Name: .��-�� C-�=�t-- � Phone Number: L�- 7 7 �� %,� � ����
�, _ � �
� �:� �' Mailing Address: Z l/ �--4i►-�-�� City: ����r�� Zip:,!�j;� ? � �
� - � � �
� �
� s1 �
`� rt, �:
PERMIT TYPE � �
�' � Municipal Sewer Connection ($35.00 per stub) $ ` ``
��
��}� `� y pipe size �� inches; material� Schedule 40 air tested• cast iron A �` �'�
��� ' ���_ ����
k SAC Charge($950.00)must accompany all sewer permit applications unless prepaid. If not prepaid, ����` �
n �
"�-� ` a sewer connection permit will not be issued. `�� � �'�
�,� :
:� �;�r����,�
s �I.�M .F;.F i, S ..,,, .,.
� � Munici al Water Connection $35.00 er stub $ ��" �
� � � P � P ) � � �
�.�� �
Pr � 1 pipe size inches; material copper; other �'a ��..�
y*S r 't�� ..:
�;�< `: �'� WATER METERS must be picked up and paid for at City Hall. Fati ''���
(5/8" meters= $139.00; 3/4" meters= $191.00; 1" meters = $247.00) ���$�
.; �����
{ ke Separate Plumbing Permit issued for water meter. ���
;_:�'t Water meters must be set and sealed by Orono Water Department(473-7357)upon completion �, ��
� �. ' of ineter installation. `� ���
a °� REQUIRED minimum setbacks from drainfield and septic tanks= 75' � � `�-� &.��
'S `���� REQUIRED setback from sewer line=20' �'�'�. ���' � '" � � ���
; � �f �, .; , � .
�'<.:.�+c-< d x `..Y f
?
'�"�. d'��f'i
�'' �� �� pERMIT FEE CALCULATION r '-� ' �`' �' � ��"""� "'
,� � a y ��, � � .
� 1. Subtotal of above permit requested ��� ` ��� ' '�� �'��� �� $ '' � _��� �
r� � 2. State Surchar�e $ .50 ����'�
", �' A, #�-
�` The State Building Code Division Surcharge of$.50 per permit must be � ��,�.
r�� '�"� included for each well,sewer and water connection permit requested. �����
� ' 3. P o s t a g e & H a n d l i n� (O n l y m a i l-i n a p p l i c a t i o n s) $ 1.5 0 `�"����
' � 4. TOTAL PERMIT FEE (add lines 1-3 above) $ `��>�
P < • '�,c
6 �:� ��
- The undersi ned hereb a lies to the Ci of Orono for issuance of a Utili Permit a rees to do �� � �"'
g Y PP tY tY � g ���:
T�� �� ,; `; 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. `��������
��
� `� _
{� .�
' � i- ��.�
<
y 7 � , �
� ' � : �c-��;�, ,�-��—. .-- � � x���a
t �� Signature of Applicant: �� Date: / �s ,�` �
� �
w ��
� �
,
� \� � tt��
� . ...rs ..�.�-�.��. , t���: �yrr<.:�!.�. .� :��, ._�-_.�:_ �.__ � . . :. 3 A.__x..� eS�t_...,.,,_ . �:3 . -.. .. _.s,j c,,.z. _. ,.,�,...,. tm. ._�::�.s,h..,�.,nu���.:.�E��.e: ;�P..��. , ._
ro� �.
D TE TIME
CITY OF ORONO CALLED IN ��
INSPECTION NQ�I E SCHEDULED �/ �5�/9� :t�O
PERMiT NO. �� �� COMPLETED �
ADDRESS `
OWNER CONTR.
TELEPHONE NO. '�7 7" 56 ��
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLINCi
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAi�SHOREJWETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 W/�.BD. 12 WATE K-UP 17 SITE INSPECTION
Q
= OS FINAL EWER HOOK- 06 PROGRESS
~ 07 DEMd—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
�Q 07 DEM�FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBINO FINAL 28 CEDAR SHINGLES 36 FOUNDATION FiEMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
� � l f'-
�
j � �
O y
� �
�
O
�
W � � �
�
Q
�
2
W
�
W
�
�
d C WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
W
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -, pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR - CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspe tion 24 hours in advance.47�73�J7
OwnerlContracto 0
Inspector. �
White Copyllnspector's File Canary CopylSite Notice