HomeMy WebLinkAbout1992-004812 - water connection PERMIT
CITY OF ORONO PERMIT TYPE: SEWER b WATER
1335 Brown Rd. South - P.O. Box 66 Permit Number: 004S12
Crystal Bay Minnesota 55323 Doe Issued: 11/23/92
(612) 473-7357
SITE ADDRESS:
2480 OLD BEACH RID
P , I , N . : 21-117-23-22-0004
DESCRIPTION:
WATER CONNECTION
Sewer 6 Water Permit Type WATER CONNECTION
Sewer & Water Work Type RESIDENCE
REMARKS:
FEE SUMMARY: T
F140410-Er, EFF."rLIL.
Base Fee
Surcharge --------------
Total Fee $30 . SO [HIEL"I"' Ti i0l.5Z-11
1:,T- 7i;-;*' ikik'
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CONTRACTOR: - Applicant - OWNER: 111 KE
WIDMER IN( 24461495 MODRESS
PO BOX 219 2480 OLD BEACH RID
'IRONO 5539i
ST BONIFACIUS MN 55379 MN
(612) 446-149S
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREES TO DO FILL. WORK IN STRICT COMPLIANCE WITH ALL CITY OF
OIRI-Dr-411:f ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREM
L ENTS .
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 ( 1335 So Brown Rd) SEWER WATER
Crystal Bay, MN 55323
I:-You maI ya pp tor utility permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees 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 (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY S` F= 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 473-7357.
24 hour notice required.
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JOB SITE ADDRESS:
Occupancy Type: Residential Commercial
OWNER'S NAME: _�' �-��' Phone No. :
Mailing Address : ; _ City: � r=�
CONTRACTOR'S NAME: �7y_ T�' ,� Bus . P one:
Mailing Address : 2 iy� - City: y- Zip:
PERMIT TYPE AND FEE CALCULATION
MUNICIPAL SEWER CONNECTION ( $30 . 00 per stub) $
pipe size inches ; material PVC (on sand fill ) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless
prepaid . If not prepaid , a sewer connection permit will not be issued.
MUNICIPAL WATER CONNECTION ( $30 . 00 per stub) $
pipe size ,, inches ; material copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $133 . 00 ; 3/4" meters = $181 . 00 ; 1" meters = $235. 00 )
Water meters must be set and sealed by Orono Water Department (473-7357)
upon completion of meter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75 '
REQUIRED setback from sewer line = 201
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1. Subtotal of above permit requested $
2 . State Surcharge . 50
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
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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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: ` /��'�' Gam_ Date :
P �-
DATE? TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �' T
PERMIT NO. 6,t/_ 2 COMPLETED (V
ADDRESS YM IlfZ
OWNER CONTR.
TELEPHONE NO. `f�� - ,L �Jr—
DESCRIPTION DESCRIPTION
LQ 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z04 WALL BD. 1 2 WATER HOOK-UP 34 TREE REMOVAL
Q 0MN—A 13 M NON 17 SITE INSPECTION
SITE 14SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
OWNER/CONTRACTOR TO MEET YOU:_YES NO /
COMMENTS:
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WORK ACTORY:PROCEED C PROJECTCOMPLETE
❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
Ej CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. c PHOTO TAKEN
INSPECTOR WILL RETURN
11 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
El INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor s' _
Inspector.
White Copylinspector's File Canary Copy/Site Notice