HomeMy WebLinkAbout2002-P05889 - sewer connection k PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P05889
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 12/5/2002
SITE ADDRESS: 4496 North Shore Dr
Mound,MN 55364
PID: 07-117-23-31-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection
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: M&W Water&Sewer Utility Inc. OWNER: Wayne J.and Karen D.Soojian
2760 183rd.Lane NW 4496 North Shore Dr
Cedar,MN 55011 Mound MN 55364
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.
PLICANT E SIGNATURE SSUED BY SIGNATURE
Conies:1-File(Siknitures Reauired).1-Awlicant,l-Monthly Reports. 1-Assessina, 1-Finance Page 1
(Updated 5/3/02)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORMATION
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 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(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 required.
JOB SITE ADDRESS: Nai 5�cc r
Occupancy Type: Residential Commercial
Owner's Name: Phone Number:
Mailing Address: City: Zip:
Contractor's Name: fypkv eAoPy'- , Phone Number: -1W153- 1'363
Mailing Address: 7-1 ko 1$__�t� Z-n. tV.W City: 631\, Zip: 5561
PERMIT TYPE Connections ❑Repairs ❑Disconnect (Check One)
SAC Charge (2002 rate $1,200.00) $ (Set Rate)
Sac Charge must accompany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size�inches; material PVC Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
(952-249-4600) upon completion of meter installation.
REQUIRED minimum setbacks from drain field and septic tanks=75'
REQUIRED setback from sewer line =20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surcharge $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage & Handling (Only mail-in applications) $ 1.50 (Mail In Only)
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 Minnesota, and certifies that all statements
made on this application are complete, true and correct.
Signature of Applicant: ��y,�x, _ (1)ttz PAe.i.7 Date: �Z
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DATE TI
CITY OF ORONO CALLED IN
INSPECTION NO CE SCHEDULED _{a"I 2 -D-2- to® ✓"
PERMIT NO. COMPLETED 11-1 -®
ADDRESS q& alp eC_ggd? Dn.
OWNER CONTR. M+ 0- aJ�17�4-'e
TELEPHONE NO. Zz L), Lal f2 70
DESCRIPTION ��-.,�e� )A06)t VA
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILUNG
Q02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREIWETLANDS
y 03 INSULATION 24/25 WOOD BURNERIFIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12WATE HOOK-UP 17 SITE INSPECTION
Q 05 FlNAL1 HOOK-U 06 PROGRESS
07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL �// 36 FOUNDATIOWREMOVAL
Z OWNEWCONTRACTOR TO MEET YOU:XYES`NO
y COMMENTS: 1,06k,
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4141 ❑WORK SATISFACTORY.PROCEED ❑PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V 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.
Call for the next Inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector•. v
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