HomeMy WebLinkAbout2006-P10175 - sewer connection � PERMIT
CITY OF ORONO
275►a Kelley Parkway- PO Box 66 Permit Number: P10175
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952)249-4600 Date Issued:
8/2/2006
SITE ADDRESS: 2180 North Shore Dr Unit#
Wayzata,MN 55391
PID: 10-117-23-31-0098
DESCRIPTION:
Proposed Use: Institutional-Schools
Pernut Class: General
Pernut Type:
Sewer and Water Pernut Permit Sub-type(s): Sewer Connecfion
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Pete's Water&Sewer,Inc. OWNER: Hill School of Minnesota,Inc.
800 Lowry Avenue NE 2180 North Shore Dr
Minneapolis,MN 55418 Wayzata,MN 55391
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 SIG ATURE UED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� FOR CITY USE ONLY
O��j�� City of Orono Date Received: p��#
'r� P.O.Box 66
y�,.� 2750 Kelley Pazkway ❑In-House SAC Determinafion Form Completed
� J�MrA� Crystal Bay,MN 55323
S��:y�,� (952)249-4600 Approved By(If Required):
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CITY OF ORONO—SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require appmval by the Building Officiai and/or Public Works Department')
(ALL PERMITS Mav be subiect to further review and mav not be issued when the applicallon is received)
GENERAL INFORMATION
I. 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. Perrnit cards will
be sent by return mail within 2 business days.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless ttie perxnit cazd is available on the job site.
5. Utility connection permits 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 ezpress
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(952}249-4600,24+hour notice required.
TYPE OF PERNIIT
Check All That A 1
❑Residential(May Require Approval) ❑Commercial(Approval Reyuired)
❑New Connection ❑Additional Connection �Re-Connection ❑Repairs ❑Disconnect
Job Site/Owner Information: —�
Site Address: ,���� �i>j"%i'► ���LLI"��1��'
Owner:�l������'/�C�D f Mailing Address: Srr'�i�
City: �ti��t v�it TA Zip:
Home Phone: Alternate Phone: n ����-���-���
I�QL�t°I��G�A/"I�Pi�'��'!���
Contractor Information:
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Contractor: ���4_��%'��Y�veGti�' Contact Person:
Address: ��U � � rt State License#: ,_�r����
City: ��� ��✓ Zip:��y� Expiration Date:
Phone: �p��—%�—���� Alternate Phone: `,�/-�:����y
_SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can deteiinine if applicable)
(If not prepaid,a sewer connection permit wW not be issned)
�Sewer Connection/Disconnect/Repair(535.00/Per Stub) S
� Pipe size inches;material Schd 40 sir tested; cast iron
Water Connecrion/Disconnect/Repair(535.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Reyuested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
A�D�"i'I(J�iAL R+1Ft�A�L4'I"It3�T--V��TER ME I"ER,S
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate nermit•
• WATER METERS mast be set and sealed by Oroao Water Department (952) 249-4600, apoa
complerion of ineter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,agrees to do
a11 work in strict accordance with the ardinances of the City and the regulations of the State vf
Minnesota,and certifies that all statements made on this application are,true and corcect.
Applicant•�/1;� '� Date: D�
, , , ,
DATE E
CITY OF ORONO CALLED IN
INSPECTION N I SCHEDULED ' � -�
PERMIT N0. ��� COMP TED .�3`�� �3�
ADDRESS d ��" 1 '
OWNER CONTR, e '.s .�-ew�r�
TELEPHONE NO. �I� "�S� 1`CO� LI? a�. ���"`�`-IC
� DESCRIPTION O
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 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 RI. 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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WORK SATISFACTORY:PROCEED [.� PROJECT COMPLETE
� ❑ ORRECT WORK&PROCEED ! i ISSUE CERTIFICATE OF OCCUPANCY
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0 O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnedContractor on ite:
Inspector. � �S
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