HomeMy WebLinkAbout1992-004691 - sewer connection PERMIT
� CITY OF ORONO '
1335 BROWN RD s , Box 66 � PERMIT TYPE: '-:���� L� �����
CRYSTAL BAY, MN 55 3 2 3 �ermit Number: =fi�'�'�'��'
473-7357 ##'��:�'`�`�'�'i
Date Issued:
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APPLICANTiPERMITE IGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box.66 (1335 So Brown Rd) SEWER WATER
- Crystal Bay, MN 55323
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. ou maj y�apply�tor 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 sam�e day the application is received.
3. P�nits are nat va.].id imtil yoni reoeive a �*'m;t card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility oonnection pex�uts may be issued to licensed contsactors only.
6. Contact the Public Works Department (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY STRF�r AND DO NOT TAP ANY MAIN without express approval of the
Public Works Department. Issuanoe of a permit does not grant this approval.
7. Al1 work must be done in accordance with State Code requirements.
8. Al1 work must be inspected before it is oovered. Call 473-7357.
24 haur mtiae required-
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JOB SITE ADDRESS: l"��� ��'�"�� `��i���� G��`—
Occupancy Type: Residential �_Commercial
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OWNER'S NAME: �%-r�� '��'� Phone No. : � � ` �
Mailing Address: City:
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CONTRACTOR'S NAN�:: ,�a�z- �r--���L_ ����ti'Y� Bus. P o�e: ��� �.���
Mailin g Address: c y�j s,a' City:� ,.��i�- Zip: ��<,��
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P$RMIT TYPE AND FEE CALCULATION
MIINICIPAL S� CONNECTION ( $30. O�r stub) $
pipe size Lt 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 issued.
MONICIPAL 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 campletion of ineter installation.
REQUIRED minimum setbacks f rom drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20 '
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1. 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 co�lete, true anyl_correct.
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Signature of Applicant� .-��'�� �����z�� Date: �C� ���� � �-
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO��CE SCHEDULED �D�.?-�IL �/ y"�
PERMIT NO. � COMPLETED K ' y �
ADDRESS v J d(�-° �� S
OWNER S � CONTR. ����('
TELEPHONE NO.
� DESCRIPTION s P/�'" d
llr 01 FOOTING 11 MECHANICALRI 16WELLTESTPUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
�
03INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 ON 17 SITE INSPECTION
� 07 DEMO—SITE 4 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 S T. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d �WORK SATISFACTORY:PROCEED �_, PROJECT COMPLETE
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� L� CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. n pHOTOTAKEN
INSPECTOR WILL REfURN �
C� STOP ORDER POSTED.CALL INSPECTOR
�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra on�e:
Inspector.
White Copylinspector's 'le Canary Copy/Site Notice