HomeMy WebLinkAbout2005-P08827 - sewer repair � *� PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P08827
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
6/13/2005
SITE ADDRESS: 3445 Livingston Ave Unit#
WAYZATA,MN 55391
P��� 17-117-23-43-0065
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Permit Type: Sewer and Water PernZit Permit Sub-type(s): Sewer Repair
DETAILS:
Approved perresolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Tonka Plumbing Heating&Cooling Inc. OWNER: CAROLYN M TILLOTSON
265 Cty Rd 110 North 3445 LNINGSTON AVE
Mound,MN 55364 WAYZATA MN 55391
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 PER EE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
,��� Clty of OrOnO Date Received: Permit#
O Y � P.O.Box 66
a;„;.,,,,� 2750 Kelley Parkway ❑In-House SACDeterniination Form Completed
� ��j�?��r;>'_ � Crystal Bay,MN 55323
� �'',(����..�o'' (952)249-4600 Approved By(If Required):
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CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by tl�e Building Official and/or Public Works Department*)
(ALL PERMITS- Mav be subiect to further review and mav not be issued when the aonlication is received)
GENERAL INFORMATION
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 fee shown below. Pernut cards will
be sent by reiuin mail within 2 business days.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the peinut card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600) for utility stub as-built locarions.
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+hour notice required.
TYPE OF PERMIT
(Check All That Ap ly)
�.�Zesidential(May Require Approval) ❑ Commercial(Approval Required)
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❑New Connection ❑ Additional Connection ❑ Re-Connection V��pairs ❑ Disconnect
Job Site/ Owner Information:
Site Address: ���l�,s ��4��/��'� � ,� � �/2� ,�t
Owner: W% Z L p%C�a 1J Mailing Address: ��f'�2
City: C�i20 7-� Zip:
Home Phone: � ��-'�6S-��ll/ Alternate Phone:
Contractor Information:
Contractor: . j X���u m•�i �ntact Person: ��G��%-
Address: �� � ��/U �ate License #:
City: �'�b K�tJ7 Zip�byExpiration Date:
Phone: �(,� ^���"�3c�� Alternate Phone: �S;�--3��C= -cr-�-/,y
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�� - �� �� ��: . ;� '����� DETERMINING���PERMIT�FEES � �
❑SAC Charge(2005 Rate=$1,450.00) � =�.--_ —*� _ �
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can deternune if applicable)
(If not prepaid,a sewer connection permit will not be issued)
❑ Sewer Connection/Disconne¢t%Repai�35.00/Per Stub) $
Pipe size inches;mater'�1�d 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Pernut 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 INFORMATION-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 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,true and correct.
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Applicant: Date: ��� � �--� �
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DATE TIME
CITY OF ORONO CALLED IN �a-/3" ��
INSPECTION N TICEy SCHEDULED �Ly-o s_ i U 5 O,4�ft.(
PERMIT NO. U� D� COMPLETED
ADDRESS ���� �� Ll�`���5�'l'�
OWNER CONTR. ��� ��'��.
TELEPHONE NO. �L'�� �D I �7.��� '
� DESCRIPTION b� "� ��'�-
� 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. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL �EWER HOOK-UP '��7a((" 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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� v�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
Owner/Contractor on site:
Inspector. ��� ./�/.�
White Copy/lnspector's File Canary CopylSite Notice