HomeMy WebLinkAbout2007-P10718 - sewer disconnect PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P10718
is rystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 1/25/2007
SITE ADDRESS: 4731 North Shore Dr Unit#
Mound,MN 55364
PID: 07-117-23-32-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Disconnect
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: Kevitt Exc.Inc. OWNER: Hessburg Development
3335 Pennsylvania Ave No 4165 Shoreline Drive
Crystal,MN 55427 Spring Park,MN 55384
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.
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
e
FOR CITY USE ONLY.
oCity of Orono Date Received ; .Permit#
D a Q P.O.Box 66
•, 2750 Kelley Parkway ❑In-Hou se SAC Determination Form Completed. .
y , Crystal Bay,MN 55323
(952)249-4600 Approved'By(If Required):
s
CITY OF ORONO—SEWER&WATER/GENERAL PERAUT
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
(ALL PERMITS- May be subject to further review and may not be issued when the anniication is received)
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 within 2 business days.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pemut 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.
. TYPE OF PER-NIIT
(Check All That A 'ply)
❑Residential(May Require Approval) ❑Commercial(Approval Required)
❑New Connection ❑Additional Connection ❑Re-Connection ❑Repairs Disconnect
Job Site/Owrier Information:
Site Address: 41,731 V6 e e /'1 v
Owner: s c�dy Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Contact Person: �/ ✓dam ,���
Address: �3 3 n���r//L �/14 State License#: 2, 6
Z 7 I
City: Cr�J�u' l AfA. Zip: Expiration Date: Z l
Phone: 76 -Y`�- 3s"--") Alternate Phone: Cl 2.- Z° 1 33 -3
'� IETERIVIINING PERMIT.FEES . ., ':
❑ SAC Charge(2005 Rate=$1,550.00) $
(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)
Sewer Connection(/
Disconnect epair($35.00/Per Stub) $
Pipe size in erial Schd 40 air tested; cast iron
❑ Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches; material Schd 40 air tested; copper
1. SUBTOTAL of Pernlit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-hi 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 permit.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of meter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all work in strict accord ith the ordinances of the City and the regulations of the State of
Minnesota, and certi, s that statements made on t i application are,true and correct.
Applicant: Date: "
1 DATE TIME f
CITY OF ORONO CALLED IN /-�7 7
INSPECTION NO �jE SCHEDULED
PERMIT NO. /cE 7/ COMPLETED` a _
ADDRESS
OWNER CONTR. s'I `
TELEPHONE NO. �fZ 2425 3/�7
DESCRIPTION Z)/S IS L-fir
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING 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. (J52) 249-4600
Owner/Contractor o
Inspector.
White CopylInspector's File Canary Copy/Site Notice