HomeMy WebLinkAbout1999-012283 - sewer/water connect PERMIT
' CiTY O�Tc'3�RON0 PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 Permit Number: = `
: i._._:; =:.. �� _..��;
Crystal Bay, Minnesota 55323 Date Issued: �
(612) 249-4600 - ��---_ �
' �f..���=�F
SITE ADDRESS:
... . _ _ `._._ -`.1(`•<'�..._�( .`j:ai ,-. . .�
,...;;:;�
; .�.��
I—` i i� —i i —__��—�_� i —�{_ii„ii_�!
DESCRIPTION:
. _ ... t._ . . _.. . _ . ._ .
_�y i_N t, �i u.;y.:r=';' �t't;I�__ `s '.*''i='�.�`° _i:�4i;�`. _. .:.-: ? �.�i
_ "':i�}"!� ... 4��`.�.•'r.?i� �L�f�ii'F:, ^.`'1�.��v �.��'�i_.�_. ._......
REMARKS:
FEE SUMMARY:
� :..�.� . .�._ �..?;.,� ;.4..
�>€�r�F F-�;��:_.�-= . - � �:"�
,-,-�,-�� --'�� __________..:�`�.��:'�
CONTRACTOR: ._ :_f..:��i i;y_;i;;: _ OWNER:
�. _: -� : � � : -
. . _. . . . . _� _ __. _ . ._ __ !j`. _ . _ . ._...__ .. . _ :
:��t_'j, ! ! ;_;��}V, f_`r;-�`:.. .'1!1 = _ . ..{.�d�_. ._.. . :_'it� ;':i�:;�-
_ ,...,:-- - � . - -- -
..- . : ...:,: _.
�.� _ :
h'� i'.i;i-.=_i�"�.�.? ,-,::: : .: - -
S �M=�.s�.! '�7"+ C` . _ _ _ . _ _. _ ., , :. ,.
yf{yw�*}(.�. ���iSj l{{�'�.j,.t�y.[��S'.{��..p... },,,�.n.y{.w..�r�jr....�.},i a. .p .{ f+� . . ..
i t 3i.. ..3�.L..i...�t'.r.�.i 43��F{.«R.f { .�!.j..{,.X{ :��is{�t.�.~i.l�'4t. �L� :.: ' � �. i�V 3� 1 1�J.. �Y��... F !:1 ��� jf 7 i
� I.�e :R �.: . i `..., ��.. : �
�==F'�c:.:I�I�� �at�� ��r���`� T�;� t���� ��i_ �:�� ,. _#` � _ . i;I��'�' �:;ii1�-i��'��._ ,� . . _
� t���`��t�,�t�I �`€�t'���v��';�,:t`:%.- t��� =i'��"E. �.fi� .�_�.�! .__e _ _'�'4�,�T°`!iy {�#.F€-`� �,�,�.�.�... . _ ._ ',, ! _ �. . ._. �
. �
APPLICANT/PER TEE SIGNATURE ISSUED BY:SIGNATUAE
. �ITY OF ORONO APPLICATION FOR UTILITY PERNIITS
Box 66 (2750 Kelley Parkway) SEWER/WATER 1 -Z;Z ���
Crystal Bay, MN 55383
GENERAL INFORMATION
i. You may apply for utility pemuts 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.
4. Work must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Departrnent(249-4600)for utiliry stub as-built locations. DO NOT EXCAVATE
IN ANY STREET AND DO NOT TAP ANY MAIN without e�cpress 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. All work must be inspected before it is covered. Call 249-4600.
24 hour notice required.
JOB SITE ADDRESS: -� 7�`i�"' L-z-'��c� _ Z��� C�
Occupancy Type: �_Residential Commercial
Owner's Name: ;�D �� � Phone Number•
Mailing Address: _ City: 7ap:
Contractor's Name: 2�-,--� � � Phone Nu��: �7 7—G �-�?�
Mailing Address: �:�� :��c� City: 7ap: �i� � '��J3
PERMIT TYPE _���
Municipal Sewer Connection ($35.00 per stub $ �`�
pi pe size�inches; material ���LSchedule 40 air tested; cast iron
SAC Charge ($1,050.00} must accompany all sewer permit applications unless prepaid. If not
� prepaid, a sewer connection permit will not be issued. �
=,c
Municipal Water Connection ($35.00 per stub) ,i $ �`�
pi pe size inches; material �' cop�er; other �
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters= $130.00; 3/4" meters= $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(249-4600) upon completion
of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks= 75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION --7 , c n
1. Subtotal of above permit requested $ /�' ''
2. State Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Posta�e &Handlin� (Only mail-in applications) $ �LL
4. TOTAL PERNIIT FEE (add lines 1-3 above) $ 7C, S O
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 conect.
Signature�f Apnc�ant:
s����'L`iJ�7 -�J—�,"--' Date: � � '���— 1C�
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC�... � SCHEDULED � a��vv
PERMIT NO. COMPLETED I� �� z'``��
ADDRESS ! CJ� �1 U t 11��(/1 �-{)-�2..
OWNER CONTR. � '�- �' K ��Ln'l�
TELEPHONE NO. `t��- ���J
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
o ,� s ir s,
�.
�
0
�
w
�
Q
�n pvz` r✓.;
� 5
z
W -
�
W
�
�
d
� �WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑ CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector./%/CQ�c- �C�v�`J
White Copyllnspecior's File Canary CopylSite Notice