HomeMy WebLinkAbout2006-P09799 - sewer connect PERMIT
CITY OF ORONO Permit Number:
2750 I�elley Parkway- PO Box 66 P09799
Cr'�istal Bay, Minnesota 55323 Permit Type:
Sewer and Water Pernut
(952) 249-4600 Date Issued: 4/25/2006
SITE ADDRESS: 3145 North Shore Dr Unit#
Wayzata,MN 55391
PID: 09-117-23-33-0013
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pcrmit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer Connection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Olson Construction Co. OWNER: Sveron Peterson
6970 Inwood Road 3145 North Shore Dr
Cologne,MN 55322 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 PE MITEE SIGNATURE ISSUED BY SIGNATURE
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Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
Aar-25-2006 11:43am From-CITY OF ORONO +9522494616 T-314 P.001/001 F-052
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��FOIt CITY US�OP�L1Gi'
DaLe R�caw�1:� ,�;. Pcmrtt# ��
City oiOrono . • , �, ' ;. '
'��� p,p.Box 66 ��,_kqy�SAC petertrrination Form Completed
0•. � 2750 Ktlfcy Parkway . � ,
���d� Crybtal Bay�MN 55323 APP�oved Sy�f Required): .
(952)z49-A600
�o CIT'Y OF ORONO—SE�ER&'WATEYt/GENERAL pERM�T
(•Notc:Same pe„ni�s rrn�y raqu�re flFP�o.'a1 by the B�;iding OY�icial andlor Public works I�epanment')
�/�t, PE i be sub'e to r revl w a ms� nnt e iasu wh n the lic, ion recC' ed)
CYENERAL 1NFORMATIQN - ' .
1. you may apply for ucilicy pei�u by mait or in person ac the City office6.
2, Mailed in applications are subjecc to ti�e posca�e and handling fee shown betow. Pormit eards will
be seut by Teturn mail withu►Z business days.
3. Permits are not volid uneil yau receive a permit card.
4, Work must not bcgin ualess the permit card is available on the job site.
5. Utility conneetion pennits may be issutd to tieensed conocactors on1y.
6. Contact Lhe Publie Works DepaT�►ent(952-249-4600)for utility stub as-built locations.
DO N�T'EXCA�ATE IN ANY STRTE'f AND DO 1vOT TAP ANY MAY1�I without enpress
approval of the Pubtic Works Dep�ctment. Issuauce of a permit does not granc dus approval.
7, All work inust be done in accocdance with State Code requiremcnts.
8, All work must be iuspected befon it is eovered. Call(952)z49-46W,2a+hour notice required.
� . • TYPE`OF�PERMY'T , � � � . � - . '
� � , � � (Check Al1 That A 1 ) . . �` �� � .
�Residential(I�tay Require Approval) ❑Commercial(Approyal Required) .
❑New Connection []Additional Co�ecrion ,�RaConnection �Repairs ❑Disconneet
Job Site/Owaer Information:
Site Address: I r ��
Owner:
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: c�cy: ����.`�-�.1�-�-- zip: ,
Home Phone: � Altemate Phone: �
, Contractor Information:
� Contractor: (�;L,�n ��r � �o�tact Person� �)
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� Address: �'/�
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. City:
� ��_ ,��C��—�j�;�� Alternate Phone: �Q1p�_"Z�C��`�'�
. Phone�
Aar-25-2006 11:43am From-CITY OF ORONO +9522A94616 T-314 P.002/002 F-052
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❑SAC Chargc(2005 Rste=51,550.00) $
(SAC Charge xnust accompany all sewer permit applications untess prepaid)
(Orono Ciry Sta,tf can dctermine if applicable)
(Cf not prepAid,a sewer conaection permit will aot be issued)
�Sewer Connection/Disconnect!Repair($35.00/Per Stub) S��q
Pipa size,�inches;matecial�_Schc140 air oesced; cast uon
❑1�Vater Conncctian/Disconnect/RepAir($35.00/Per Stub) $
Pipe size iuches;maberial Schd 40 air tested; copper
1. SiJB1 OTAL of Pernut Requested: �
2. STATE SUCLGHARGE $ •sp
3. pOSTAGfi&HANDLING(Only on Mail-Tn Applicarions) S 1.50
4. 'L'OTAL P�YtMIT FEIi(Add Lincs 1-3 Abovc) $
� � .ADl7T'rIONAL TNFQRMATCON—�WATER METERS
■ WATER METERS�mLct be picked up and paid for at Orono City Hall,these ace an a seoarate pe�mit.
■ WATER ME'1'ERS must be set and scaled by Orono Water Depariment (952)249-4600, upon
completion of ineter insta!{ation.
The undersigned h�reby applies to the City of 4rono for issua�tce of a Utiliry Pernut,agrees to do
all work in strict accordance with the ordinances of the City and the rtgu�arions of the State of
Minnesota,and eertifies that all statements made on this application arc,true and correct.
Applicant� ` Date� ,'7"v��-�