HomeMy WebLinkAbout1996-007956 - sewer disconnect , * PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �4;���i�:� i� �}����
Crystal Bay, Minnesota 55323 Permit Number: {�i y.�,���,
(612)473-7357 Date Issued:
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: -- A���lic.�nt. — OWNER:
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PPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� "' C1"1'Y OF ORONU APPLICATION FOIt UTILITY PEI2MI'TS
Box 66 (2750 Kelley Parkway) SCWER/WATER
Crystal 13ay, MN 55323
GCNCRAL INFORMATION ` � J �
1. You may apply for utility permits by mail or in person at the City offices.
2. Mailed in applications are suUject to the postage and handling fees shown below. Permit cards will be sent by
return mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(473-7357)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
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 hour notice required.
JOBSITEADDI�SS: ��� � ������� �
Occupancy Type: x R identi�l Commercial �
Owner's Name: �.�,� �'/`'1jQ��u�� ���_ Phone Number:
Mailing Address: ���City: 7�:
Contractor's Name: �-l� ��"Phone Number: l� Z/— o j Z S
Mailing Address: �/ 0 7 � City: `�-�� 7ap; .5.� �/
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PERMIT TYP�
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material PVC (on sand fill); cast iron
SAC Charge($850.00)must accompany all sewer permit applications unless prepaid. If not prepaid,
a sewer connection permit will not be issued.
Mu�iicip�l Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City �Iall.
(5/8" meters = $139.00; 3/4" meters= $191.00; 1" meters = $247.U0)
Separate Plumbing Permit issued for water meter.
Water meters►nust be sct and sealed by Orono Water llepartment(473-7357)upon completion
of ineter install.�tion.
R�QUIRCD minimum setbacks from drainfield and seplic tanks = 75'
REQUIRCD setback from sewer line=20'
P�,ItMIT �EF, CALCULAT(ON
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
7'I�e State Building Code Division Surcharge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta�e & Handling (Only mail-in applications) $ 1.50
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 City and the regulations of the State of
Mim�esota, and certifies that all statements made on this application are complete, true and correct.
Signature of Applicant: 1?ate:��/s� �(P ^
DATE TIME
CITY OF ORONO CALLED IN �-/S �1
INSPECTION NOTICE 1 SCHEDULED ���5 ���`�
PERMIT N0. � ���`� COMPLETED
ADDRESS ��.� L ��`2.�h .:� �i_�,:.. ,z-- ��Z.i
OWNER ��L�� CONTR. �- '� �,{�i3�.�'-r'� ��`�'�--
TELEPHONE NO. ���' �'f'� �
� DESCRIPTION --L c�-c?� �C a�.,t-y2,,�'_�
� Ot FOOTINCi 11 MECHANICAL RI 18 DCCAV/ORADINCi/FIWNCi
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
� 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z pq yy p, 12 WATER HOOK-UP 17 SITE INSPECTION
� FlN,q� 14 SEWER HOOK-UO p6 PROGRESS
� �
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINC3 RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
-� 10 PLUMBIN�FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK 8 PROCEED G ISSUE RTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORECONERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. LpHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOii
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
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