HomeMy WebLinkAbout2004-P08253 - sewer connect � . . ,
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Pos2s3
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Pernut
(952) 249-4600 Date Issued: i2i2i2ooa
SITE ADDRESS: 2170 Minnetonka Ave
Wayzata,MI�T 55391
P I D: 10-117-23-31-0093
DESCRI PTION:
Proposed Use: Residenrial
Permit Class: General
Pernut Type: Sewer and Water Pernut Permit Sub-type(s): Sewer Connecrion
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Tonka Plumbing OWNER: Michael&Jeanie McClelland
265 Cty Rd 110 North 2170 Minnetonka Ave. (P.O.Box 45)
Mound,MN 55364 Crystal Bay,MN 55323
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 DING CODE REQUIREMENTS.
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APPLI ANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Si�nitures Required), 1-Atmlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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(LTpdated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323 y' -
GENERAL INFORMATION
1. You may apply for utility pernuts by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Pemut cards will be sent by return mail the same day
the application is received.
3. Permits are not valid until}�ou receive a permit card.
4. Work must not begin unless the peniut card is available on the job site.
5. Utility comiection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Department(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 Depamnent. Issuance of a pemut 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(9�2)249-4600, 24 hour notice required.
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JOB SITE ADDRESS: �I^1 O M•n r���K � �_
Occupancy Type: �(f Residential Commercial
Owner's Name: Uoo�-I��� � ��S Phone Number:
Mailing Address: City: Zip:
Contracto►-'s Name: onlca ��r, . Phoue Numb r: �►5� arJ--7�f�
Mailiug Address: la-o C►•i-�n �2�. v City: (�,n�'i-s�� Zip: 5S 6
PERMIT TYPE �onnections ❑Repairs ❑Disconnect (Check One)
5AC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accompany all sewer pennit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Se er Con-e ion/ sconnect/Repair ($35.00 per stub) $ �S� ��
pipe size inches; material �,kS�,�Schd 40 air tested; ✓cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; inaterial 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
(952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEE CALCULATION
1. Subtotal of above pennit requested $ 3 S. ��
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well,sewer and water connection pemut requested.
3. Posta�e &Handling (Only mail-in applications) $ 1.50 (Mail In Only)
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 � y and the regulations of the State of Minnesota, and certifies that all statements
made on this application are comp t , t correct.
Signature of Applicant: Date: o� '�' �
�H'� DATE TIME v
CITY OF ORONO CALLED IN � 'a �
INSPECTION NOTICE SCHEDULED 12-3-G�( u
PERMIT NO. ('�7��53 COMPLETED �t3_oy _1. ' �
ADDRESS � (�O .� �.��1.e. 1Z�ti.��-�. A✓E .
OWNER CONTR. � I on k�= P( �� � .
TELEPHONE NO. ��� � � a ��{O� I a-�J I
� DESCRIPTION Se�'"t � �OOk�h'
� 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14�EW�—HO� 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 FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�YES_NO
v�, COMMENTS:
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����ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑C RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-460�
OwnerlCon ctor on site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice