HomeMy WebLinkAbout2004-P07873 - sewer connection 'i PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07873
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 8/23/2004
SITE ADDRESS: 4515 North Shore Dr
Mound,MN 55364
PID: 07-117-23-31-0006
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:
NOTICESIREMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $35.50
APPLICANT: Thompson Plumbing OWNER: Ian Barbour
15001 Minnetonka Ind.Rd. Stephanie Barbour
Minnetonka,MN 55345 4515 North Shore Dr
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.
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APP CAN P TEE SIG 4t�DBY�SIGNAT�URE
Copies:1-File(Signitures Required),1-Awlicant.I-Monthly Reports,1-Assessing, 1-Finance Page 1
Doc-04-2001 12:44pm From-CITY OF ORONO +9622484616 7-297 P.001/001 F-306
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CITY OF ORONO APPLICATION FOR UTILITY PERNUTS
Bog 66(2750 Kelley Parkway) SEWER/WATER
Crystal Bay,MN 55323
GENERAL INFORMATION
I. You may apply for utility permits by mail or b►person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sentby
return mail the same day the application is rea;ived.
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 Stage Code requirements.
8. All work must be inspected before it is coverei 1. Call(952)249-4600.
24 hour notice required.
JOB SITE ADDRESS: L} \ �C✓ 1�rL��j
Owner's Name; ctn,G�+ -�kc�/, x,, _ - Phone Number.Ut,;k--I.,iscl-tf ri
Mailing Address:4 C�- City:_Cj\_-Cw C, _ zkx
Contractor's Name: - Phone Number:. S!� - I
Mailing Address _ City:l�"1 �
PERMIT TYPE'
Municipal Sewer Connection ($35.00 per stub) $ I
Ver pipe size—i—inches; material, ,G�-Schedule 40 air tested; cast iron
SAC Charge(2000 rate$1,150.00)must accoazpany all sewer peanut applications unless prepaid.
V-�I A If not prepaid,a sewer connection permit will)wt be issued.
Municipal Wateronnection($35.00 per stub) $
pipe size inches; material_ copper; a
44 _
WATER METERS mus eked up and paid for at City Hall.
Water meters must be and sealed by Orono Water Department (952-2494600) upon
completion of meter stallalion.
REQUIRED minimum setbacks from drain Meld and septic tanks=75'
REQUIRED setback$om sewer line=20'
PFRM11 FEE.-CALCULATION
t. Subtat lOfa1bomm+v mit.-&'_33 rd
2. State.Surclme $ .50
The Stain Building Code Division Surcharge oi'$.50 per permit must be
included for each well,sewer and water connection permit requested.
3. Postage.&B ndiing(Only mail-in applications) $ 175.01
4. TOTAL PERMIT FEE(add linos 1-3 above) $ �T)
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.
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Signature of Applicant: I )�i 01-'n- -e�tn Date: o-0 q
V- T�j TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED k 3y
PERMIT N0. 6 ,, // COMPLETED
ADDRESS L161-5 /VC� Mer
OWNER CONTR. �� —
TELEPHONE NO. r2 2- 1
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKES HORE/WETLANDS
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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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w WORK SATISFACTORY:PROCEED I PROJECT COMPLETE
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W ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contracto site:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice