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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