HomeMy WebLinkAbout2007-P11733 - sewer/water PERMIT
CI�Y UF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11733
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued:
12/6/2007
SITE ADDRESS: 3768 North Shore Drive Unit#
Wayzata,MN 55391
PID: 08-117-23-34-0063 - --�
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
SAC Grandfathered In 1968
FEE SUMMARY: Permit Fee: $ 70.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Bohnsack&Hennen Excavating OWNER: Nancy Blair
17072 Revere Way 5501 Village Dr
Prior Lake,MN 55372 Edina,MN 55439
THE UNDERS]GNED 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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APP NT PERMIT G SI ATURE 1 SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Scptic, l-Septic) Page 1
FpR CITY USE O1�1LY
„�(�� City of Orono DateReceived: Permit#
O Q P.O.Box 66 \
2750 Kelley Pazkway ❑In-House SAC Determination Form Completed
� x;.� Crystal Bay,MN 55323 �
�y (952)249-4600 Approved Bq(If Requiredj:
CITY OF ORONO—SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
(ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is received)
GENERAL INF�RMATION
1. 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. Permit 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 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(952-249-4600)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(952)249-4600,24+hour notice reqnired.
TYPE OF PERMIT '
Check All That A 1
�Residential(May Require Approval) ❑Commercial(Approval Required)
� New Connection ❑Additional Connection �Re-Connection �Repairs ❑Disconnect
Job Site/Owner Information:
Site Address: /���p '� ►�G r-� �� �,��4 �f:
Owner: �>� 'J��^�, Mailing Address: ���`^ 2
���: o n�� � Z�p: � �3 a 3
Home Phone: �s � '��a-���� Alternate Phone: �/� 2^SO �' 6 a S �
Contractor Information:
Contractor: �� � ,, �n�1Q/l ��``'��� �¢ 5� �/c�nS o`�J�
G�ntact rcrson:
Address: �d�01 P,�f� ��` State License#:
� a
City: � 1 � Zip: �3 Expiration Date:
Phone: `� >� " �`'� I` �� g `i Alternate Phone: �91 )-� J �c ! `�'� j � I
1
�SAC Charge(2007 Rate=$1,675.00) $
(SAC Charge must accompany all sewer permit applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
�J Sewer Conn c�ion/Disconnect/Re air($35.00/Per Stub) $
Pipe size � inches;material ���-Schd 40 air tested; 0 cast iron
�Water Connection/Disconnect/Repair($35.00/Per Stub� $
Pipe size �` inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
ADDITIONAL INFORMATION—WATER iv1ETERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
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 th all statements made on this application are,true and correct.
Applicant: Date: � �—(�'�'� �
/ AT TIME �
CITY OF ORONO CALLED IN `� �
INSPECTION N ���33 SCHEDULED � " �� _f�S1S�
PERMIT NO. COMPLETED
ADDRESS �J T� /U���' ��
OWNER CONTR. ,�C����
TELEPHONE NO.
� DESCRIPTION ��� � G��' �����8�'
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION O WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO { � �
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W WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next in ction 24 hours in advance. (g52) 249-4600
Owner/Contr or sit :
Inspector. @
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