HomeMy WebLinkAbout2000-P03134 - sewer/water permit � PERMIT
C� � Y OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P03134
Crystal Bay, Minnesota 55323 Permit Type: sewer and Water Permit
(612) 249-4600 Date Issued: lo�i��2o
SITE ADDRESS: 3739 LIVINGSTON CT
WAYZATA,MN 55391
P I D: 17-117-23-34-0076
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit T e: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
yp Water Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUIIIIMARY: Permit Fee: $ 70.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: E LE c rroRTHwEST OWNER: � (e e � P S
PO 7333 � �
PL TH,MN 55447 �
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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 BUII,DING CODE REQUIREMENTS.
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APP N E I NATURE SS D BY SIGNATi.JRE
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Copies: City,Applicant,Assessor,Finance Page 1
CITY OF ORONO APPLICATION FOR UTILITY PERMITS ��� �
� Box 66 (2750 Kelley Parkway) SEWER/WATER �
Crystal Bay, MN 55323 (�i��
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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 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 permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(249-4600)for utility stub as-built locations. DO NOT EXCAVATE
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.
7. All work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Ca11249-4600.
24 hour notice e uir�d.
JOB SITE ADDRESS:
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Occupancy Type: Resi ential Commercial
Owner's Name:���/L�,d Phone Number:
Mailing Address: City: 7ap:
Contractor's Name: Phone N mb�e�.' ��7—�_Sa5"-
Mailing Address: City: ��'-C' 7�: S S3 7�
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material �Schedule 40 air tested; cast iron
SAC Charge (20 0 rate $1,100.00) must accompany all sewer permit applications unless prepaid.
If not prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size�_inches; material�_copper; other
WATER METERS must be picked up and paid for at City Hall.
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
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) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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.
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Signature of Applicant: Date: �� ^l�— ��
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DATE TIME ,�'
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED �-/� t'`�
PERMIT NO. � COMPLETED �-� � �
ADDRESS ��
OWNER CONTR. 1�°C- K
TELEPHON NO.
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/2 B-B�J FIREPLACE 34 TREE REMOVA�
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE PTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W���IVORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED : ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlCont��tor on site:
Inspector� � �'�L��� �
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