HomeMy WebLinkAbout2006-P09609 - sewer/water permit PERMIT
CITY OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 P09609
Cryst�Bay, Minnesota 55323 Permit Type:
(952) 249-4600 Sewer and Water Permit
Date Issued: 2/17/2006
SITE ADDRESS: 2665 Mapleridge La Unit#
Excelsior,MN 55331
P I D: 21-117-23-21-0004
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Permit Type:
Sewer and Water Permit Pernut Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate pemuts required:
NOTICES/REMARKS:
SAC Grandfathered in#592 08/19/64
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Final Grade,Inc OWNER: G&L Land Investment,LLC
3441 Bluff Dr 8659 Great Waters Alcove
Jordan,MN 55352 Eden Prairie,MN 55347
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 PERMITEE SIGNATURE I SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
P FOR CITY USE ONLY
City of OronO Date Received: Permit#
¢�'��'� P.O.Box 66
O O' 2�50 Kelley Parkway ❑In-House SAC Determination Form Completed
�� ir'�� �.�� Crystal Bay,MN 55323
�� s� i� y�t,�i% (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 the Building Official and/or Public Works Department*)
(ALL PERMITS- Mav be subiect to further review and mav not be issued when the aaalication is received)
GENERAL INFORMATION
l. 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. Permit cards will
be sent by return mail within 2 business days.
3. Permits are not valid until you receive a permit card.
4. Wark 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 Deparhnent(952-249-4600)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 wark 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 A 1 )
�Residential(May Require Approval) ❑ Commercial(Approval Required)
�New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect
Job Site/Owner Information:
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Site Address: c.�c�tJ���� ( ��G�.D�� �\ i��� � c� �11 e
Owner:.. �eGh� �;�,��n�i�� ,�,�?,�d�,��, Mailing Address: ��1�C�( ���S�r� ��CtC F:.
,
City: �C�E'�I F"i"��.;i'�; L Zip: ����i��
Home Phone: � Alternate Phone: ���vc'�fy,�"� �c�,�(�
Contractor Information:
Contractor: ��(��,�,��,�� .�� 1,-�{-, Contact Person: � �� .
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Address: ��`i�( I ��U�-� �f'u/� State License#: J L/�/,�
City: ��� Zip:�`.�,5.`_,��,Expiration Date:
Phone: �'( �u�-�4�1�-; I DO Alternate Phone: (���- ��(�,c�_ �u<���
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❑SAC Charge(2005 Rate=$1,450.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�Sewer Connection/Disconnect/Re air($35.00/Per Stub) $ J�, �
Pipe size�inches;material�Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; cast iron
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1. SUBTOTAL of Permit Requested: $ �.J.
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ .�� •
ADDITI4NAL INFORMATION-WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completioa 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.
Applicant: Date: ;�'1 ��'����0
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CITY OF ORONO ca��E��w�;:� � $ ��`'
INSPECTION NO IC�. `� SCHEDULED "�7 �1 C - "����n
PERMIT NO. �� i 1 COMPLETED .S " r ' L.���'
ADDRESS � �L �L%� / �`7( i�� /�.� ��� LJ�1
OWNER CONTR. �/�l� l -���_:1�,
TELEPHONE N4r.J�2f�� ��� l� � ,��� � � ����
� DESCRIPTION (- ��'Z �1� �L- � �_-
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING Rf 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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W� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C, pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 tor the next inspection 2a hours in advance. (952� 249-4600
OwnerlContractor o site: '
Inspector. �'i � � � • �
White Copyllnspector's File Canary CopylSite Notice
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I `'' DATE TIME
� CITY OF ORONO CALLED IN ��'�'��
INSPECTION NOTICE� �q SCHEDULED r� - -�' � v
PERMIT NO. �C�`'j(y� 1 COMPLETED
ADDRESS ���G'�J�� �'�l��E. ��-i�4'C �C�'�
OWNER CONTR. ����'�--� ��-f��_c--f.'e
TELEPHONE NO. U �� =��Y%� -� �/ SJ
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOO - 17 SITE INSPECTION
Q OS FINAL EWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 . 21 COMPLAINT
� 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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z4J-46��
Owner/Contractor on site:
Inspector. ���'"����-..�
White Copyllnspector's File Canary CopylSite Notice