HomeMy WebLinkAbout1993-005775 - sewer connect PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: .- ER
Orono. Minnesota 55356-0815 }t 7''
(612) 473-7357 Date Issued: .. 1,f.;4 7;,;f:;:3WAT
SITE ADDRESS:
OLD CRYSTAL BAY RD
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P . I . N . . 09-117-23-11-0002 _
DESCRIPTION:
SEWER C:01\11•E:C:T I ON
4�1.,, 4; W t•P�� Permit YP'e '•_�I_WER t�:1=st�11VEC:T I OtJ
Sewer 0. W0 t t 3 ULI i'k: T,'F' RE°w:I C? N4:
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CITY! L•! t7,C,ONO
LiNi4,A,,CE OFFICE
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REMARKS:
FEE SUMMARY:
Base Fee
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Total Fee
CONTRACTOR:
._ Applicant — OWNER:
WE'r T►�f1k1'�-::A ME.C:i-I C:t��i�1TF HC:T�:}fi'-: '�i• ''=' i_Af EW�uOC� LSE.Y' L►_{F'ME€v(.
6501 COUNTY�i INTY ROAD 1
1000 O O C:RY'�rAL L! Y RD _
(61'7') 472- 959
THE REBY. REQC, STPERMISSION MAK E T lE RE o- MPR VEM NTS•
SPEC:IF ED :ANS;. � b�YALI.::,!►1C� N STRICT. COM LLA E I. I aiT CI7Y OF
C O� PINANNE TA BUILT ING COL
REQUI I �T x...
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO .- APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
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 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 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. 414
8. All work must be inspected before it is covered. Call 473-7357.
24 hour notice required. /� �J
JOB SHE ADDRESS: L.1/-900p id Cry 5 L / k, y ,Oc
Occupancy Type: Residential Commercial
Owner's Name: 1G!(moo d i>,,r 4,,,A.t...,d' Phone Number:
Mailing Address: City: Zip:
Contractor's Name: Go e's r"^Ka de l I',....k,v-e/ Phone Number:4?- - ', -
Mailing Address: 6-5-2=q et,. .t'c /S-- City: vkic,,,,.-'c✓ Zip: s—S-s' el-
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $ r
pipe size inches; material •'to PVC (on sand fill); cast iron
SAC Charge ($750.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 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)
Separate Plumbing Permit issued for water meter.
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 = 20'
PERMIT FEE CALCULATION
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) $
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.
,. edSignature of Applicant - Date: /1---2 Y-c 3
DATE ? TIME
CITY OF ORONO CALLED IN /a_ 7 / -5 0
INSPECTION NOTICE / SCHEDULED /a_�- 5
PERMIT NO. , S--2 5 COMPLETED
ADDRESS /b v O Vile- s
OWNER NTR.
TELEPHONE NO. 47E7/ 4959
DESCRIPTION
4, 01 FOOTING 11 MECHANICAL RI 16 WELL TEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
• 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
07 DEMO—SITE 4.7tWER HOOK-UF7-- 06 PROGRESS
07 DEMO—FINAL 27 SEP1iC MAINT. 21 COMPLAINT
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09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
cl• COMMENTS:
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LU WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ElCORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on si
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice