HomeMy WebLinkAbout1993-005133 - sewer connect P�l�?VIIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 �='����' �{ �����`
Orono, Minnesota 55356-0815 Permit Number: t 3r;,;�:_;;;
(612) 473-7357 Date Issued: i�4I� �,!'�:�;
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APPLICANT/PERMITEE SIGNATURE 1SSUED BY:SIGNATURE C�j�
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (1335 So Brown Rd) � ` SEWER WATER
Crystal Bay, MN 55323
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I:You mainy a�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.
Pernut cards will be sent by return mail the sam�e day the application is received.
3. P�emnits are mt valid im�til yai reoeive a ��;t c�rd.
4. Work must not begin unless the pernut card is available on 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.
Dp NOT EXCAVATE IN ANY STRE�r AND DO NCyr TAP ANY MAIN without express approval of the
Public Works Department. Issuance of a permit does not grant this approval.
7. All work must be done in accordance with State Code requirements.
8. Al1 work must be inspected before it is covered. Call 473-7357.
24 hair no�t.ic�e required.
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JOB SITE ADDRESS: � 5
Occupancy Type: Resid nt' Commercial
OWNER'S NAME: Phone No. :
Mailing Address: City: /��i,�� •
CONTRACTOR'S NAME: � � Bus. Phone: y����-�y�s �
Mailing Address: City: ' ,Zip: �:�r5
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�s',dz, PSRMIT TYPE AND FEE CALCIILATION
MIINICIPAL SEWSR CONNECTION (�`3-9-:$fl 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 co�pletion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75 '
REQUIRED setback from sewer line = 20 '
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l. 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 complete, true and correct.
Signature of Applicant:_����it-��,L��i�''�'s���:
Date: c; -�l �s
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� ATE TIME
CITY OF ORONO CALLED IN 6�93
INSPECTION NOTICE SCHEDULED 5 z /:0 �,
PERMIT NO. _'`� /3 3 COMPLETED � �/
ADDRESS o��5 �
OWNER�,r�z�� CONTR� �/��,1�>
TELEPHONENO. '�'`�Co - /��7'�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 MET N ON 17 SITE INSPECTION
� 07 DEMO—SITE 4 SEWER HOOK-U O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
T09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PIUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
i� CORRECT UNSAFE CONDITION WITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL REfURN
L]STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
L� INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr r e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice