HomeMy WebLinkAbout1993-005095 - sewer connect PE�MIT
CITY OF ORONO '' � � PE�RMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 '_�E��E�i °� �1A?�E�i
Orono, Minnesota 55356-0815 PermitNumber: i�t}�;_�,��
(612) 473-7357 Date Issued: �y��•__;/,�:Y;
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE C���
CITY OF ORONO APPLICATION FOR DTILITY PERMITS „
Box 66 (1335 So Brown Rd) t 1 SEWER WATER
Crystal Bay, MN 55323
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I. You may�pply�or 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. ;`
Perm.i.t cards will be sent by return mlil the same day the application is received.
3. Pea�i.ts are m�t valid Until y�u reoeive a peimi.t card.
4. Work must not begin unless the permit card is availa.ble an the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY STREE'r AND DO NOT TAP ANY MAIN without �ress approval of the
Public Works Depaztment. Issuanoe of a permit does not grant this approval.
7. Al1 work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 haur mtioe required.
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JOB SITE ADDRESS: , C�� � ' "'- '
Occupancy Type: Residen al Commercial
OWNER'S NAME: /�/ � � � Phone No. : �?� -���� `
Mailing Address: •, -- City: � �� `
CONTRACTOR'S NAME: Bus . Phone: ������
Mailing Address: � � ,' � � City: �: Zip: _�,`- �
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PERMIT TYPE AND F$E CALCIILATION
MIINICIPAL SEWER CONNECTION ($30. 0� per stub) $
pipe size � _inches; material. .��:PVC (on sand fill ) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless
prepaid . If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WATER CONNECTION ($30. 00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133. 00; 3/4" meters = $181. 00; 1" meters = $235. 00)
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 f rom sewer line = 20 '
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1. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must be
included for each well, sewer and water connection permit requested.
3 . Postage � Handling (Only mail-in applications) $ 1. 50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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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 co�lete, true and correct.
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Signature of Applicant��; g �0_ " Date: �/��"�j� .--
: ; ,
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DATE TIME
CITY OF ORONO CALLED IN �F',��'�3
INSPECTION NOTICE SCHEDULED 4�-Z-`i �' ' 3 G'
PERMIT NO. SL' �S� COMPLETED t� M
ADDRESS 0 " -�t`
OWNER ��-C�t�'�`''L� CONTR. ���`��
TELEPHONE NO. ' �/ �_3 - `"f 7 �''�'
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP l 06 PROGRESS
J 07 DEMO—FINAL SEPTIC MAINT. 21 COMPLAINT
= 09 P�UMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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d �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑ CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ` pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor o site:
Inspector. ��
White Copy/lnspector's File Canary CopylSite Notice