HomeMy WebLinkAbout2006-P10561 - sewer connection ,
CiTY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P10561
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952)249-4600 Date Issued:
11/14/2006
SITE ADDRESS: 4209 North Shore Dr Unit#
Mound,MN 55364
P��� 07-117-23-43-0005
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Sewer and Water Permit Pemut Sub-type(s): Sewer Connecrion
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 35.00 vaivation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: J.S.Stewart Companies OWNER: William&Mary Titler
11099 Lamont Ave. 2184 Shadywood Rd
Hanover,MN 55341 Wayzata,MN 55391
TEIE UNDER IGNED HEREBY QUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND ES T O ALL WO IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
M SOTA BUI DING CO REQUIREMENTS.
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APPLICANT PE TEE SIGNATURE SLTED BY SIGNATURE
Copies: 1-File(Sigrzatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Sepric, 1-Sepric) Page 1
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� FOR CITY USE ONLY
,¢0� City of�ron0 Date Received: Permit#
O^ O P.O.Box 66
�;;,� 2750 Kelley Parkway ❑ In-House SAC Determination Form Completed
� ��i�?�,e`'. F Crystai Bay,MN�5323
��t';;?�k��$�o� (952)249-4600 Approved By(If Required):
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CITY OF ORONO— SEWER & WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official andlor Public Works Department*)
(ALL PERMITS- Mav be subiect to further review and ma��not be issued when the annlication is received)
� GENERAL INFORMATION
1. You inay apply for utility pernuts by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Pernut 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 peinut 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 requireinents.
8. All work must be inspected before it is covered. Call(952)249-4600, 24+hour notice required.
TYPE OF PERMIT
(Check All That Ap ly)
[�Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connection ❑Additional Connection ['r Re-Connection ❑Repairs ❑ Disconnect
Job Site/ Owner Information:
Site Address: � �Vo�-1 h �,��or� �-
�M_ '�—
Owner: �(, � � �� � Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ���--�������� Contact Person: ��s5 `�Ze�j�i�'v���
Address: 1�v�j �,���J� State License #: Cv�D
City: /�'f N Zip: 5a�3y� Expiration Date:
Phone: �(�,3— �(�-1/—�t�3�, Alternate Phone: �,�2—�4��,--:��83
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DETERMINING PERMIT FEES
❑ SAC Charge(2005 Rate=$1,450.00) $
(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)
[�e�wer Connec ion/Disconnect/Repair($35.00/Per Stub) $ 3 '`��
Pipe size�inches; material_�Schd 40 air tested; cast u�on
❑ 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&HAIv'DLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
ADDITIONAL INFORMATION—WATER METERS
• WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernlit.
■ WATER METERS must be set and sealed by Orono Water Department (9�2) 249-4600, upon
completion of ineter installation.
The undersigned ereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all work in s ict acc rdance with t ordinances of the City and the regulations of the State of
Minnesota that all sta ents made on this application are,true and conect._
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Applicant: Date: �'�� � � d �o
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�� DATE TIME v
CITY OF ORONO CALLED IN //-�(3 -U�
INSPECTION N/O�TICE SCHEDULED fl-�/-<I/r �f
PERMIT NO._1 �l',�`�Z(% � COMPLETED
ADDRESS {f�G'� ;UO�'�-� ��1C�lP_ /�
OWNER CONTR. (�•S: �,�f�Cv�iT
TELEPHONE NO. �.��.� � �J C�'�L'' �����
� DESCRIPTION
t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING CHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �j pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
C INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Ca11 for the ne t inspection 24 hours in advance. (952� 249-4600
OwnerlContr o s te:
L
Inspector.
White Copyllnspector's Fil Canary Copy/Site Notice