HomeMy WebLinkAbout1993-005137 - sewer connection ' PEI�MIT
` CITY OF ORONO PERMIT TYPE: �;
2750 Kelley Parkway • P.O. Box 815 �='t�'��' '� �•�
Orono, Minnesota55356-0815 PermitNumber: {;�_;��;;7 �
(612) 473-7357 Date Issued: �_��;���_;j��;:�;
SITE ADDRESS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATU Z'�
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CITY OF ORONO APPLICATION FOR IITILITY PERMITS
- Box 66 (1335 So Brown Rd) SEWSR WATER �/3�
Crystal Bay, MN 55323
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I: You may�pp�or 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. Pe�its are not valid until you re�eive a penait card.
4. Work must not begin unless the permit card is available an the job site.
5. Utility connection permits may be issued to licensed contractors only.
. 6. Contact the Public Works Departm�nt (473-7357) for utility stub as-built locations.
DO NOT F�CAVATE IN ANY STRg.'T AND DO NC7r 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. Call 473-7357. :
24 haur �ti�e requised.
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JOB SITE ADDRESS: ��� /l,/O�'� � �`�
Occupancy Type: Residential Commercial
OWNER'S NAME: �� � ���5�� Phone No. :
Mailing Address : City:
CONTRACTOR'S NAME: Sv `Q`"7`� `��"` Bus. Phone: LI�o�" �"
Mailing P�ddress: (�5� C �,�� , /� City: v�'to��� Zip: ��3 `/
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,�j�;u-p PERMIT TYPE AND FEE CALCIILATION
MUNICIPAL SEWER CONNECTION (�$3�8�$fl per stub) $
pipe size inches; material � PVC (on sand fill) ; cast iron
SAC Charge $700.00 ) must accompany all sewer permit applications unless
prepaid. If not prepaid, a sewer connection permit will not be issuecl.
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MIINICIPAL WATER CONNECTION ($30. 00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133. 00; 3/4" meters = $181.00; 1" meters = $235.00)
Water meters must be set and sealed by Orono Water Department (473-7357)
upon ca�pletion of ineter installation.
REQUIRED minimum setbacks f rom drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20 '
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l. Subtotal of above permit requested $
2 . State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must e
included for each well, sewer and water connection permit requested.
3. Postage � Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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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 �lete, true and correct.
Signature of Applicant: ` ���=�'� Date:�rF�� �l�
v
DATE TIME
CITY OF ORONO CALLED IN ",i - �
INSPECTION NOTICE scHE�u�eo /� � � �—�
PERMIT NO. �� -' � COMPLETED ���3�
ADDRESS /�^-�^C �/�/�,>.,.�. ; � 1
OWNER CONTR.=�/_ _ i / ,
TELEPHONE NO. ��.�= t�;'`:i
� DESCRIPTION.--�'.Lr�,��� �,
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE FIEMOVAL
Q�NAL 13 �N ON 17 SITE INSPECTION
h 7 DEMO—SITE 14 SEWER HOOK-UP �- OB PROGRESS
� 07 DEMO—FINAL 27 SEPTIC 21 COMPLAINT
i09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
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d ORK SATISFACTORY:PROCEED
W� J�PROJECT COMPLETE
W �CORRECT WORK b PROCEED �O ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor n�jte:
Inspector. U
White CopyAnspectw's �le Canary Copy/Site Notice