HomeMy WebLinkAbout1999-012105 - sewer hookup PERMIT
PITY OF ORONO
2750 Kelley Parkway - P.O. ERMIT TYPE:O. Box 66 C I:: 14 W I2C1—
Permit Number:
Crystal Bay, Minnesota 55323 (_)
(612) 249-4600 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR:
APP i icant. * OWNER:
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THE t..iNDER::; GNED HEREBY iET PERM Icuc'I riN TO MA} THE REA L IMFSOVEMENT
SPEC I F IED AND AGrlEEc..; TO ALL WORK: IN.) SI-R C ;,COMPI.....I M CE IALLr'r
reriNiD. ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
-14.001}
APPLICANT,PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER p
Crystal Bay, MN 55323 /�1
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(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 249-4600.
24 hour notice required.
JOB SITE ADDRESS: 7,26 �i/�9; ✓�✓��!���
Occupancy Type: / Residenti .5/ , 7
Commercial
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Owner's Name: f. Phone Number: — l3P
Mailing Address: /'a C ` s� City: Zip:
Contractor's Name: ��� � - Phone Number: -/ /f5—
Mailing Address/2/7 City: /34` Zip:tet - 3>f_
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material //Schedule 40 air tested; cast iron
SAC Charge ($1,050.00) 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= $130.00; 3/4" meters= $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(249-4600) 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.
Signature of Applicant: .1-z� e/V4) Date: /1 7 ��
D?TETIME
CITY OF ORONO CALLED IN ///5/9 S
INSPECTION NOTICE SCHEDULED ///7 :a)
PERMIT NO. /WHO - COMPLETED1 // 4Q' HP
ADDRESS /.,e(3 (P A.,,-)24 CJ .I�P GO-4 •
OWNER CONTR. �.C;..ncz.
TELEPHONE NO. 4/716 '• /4/
DESCRIPTION
L 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WAT : .•OK-UP 17 SITE INSPECTION
Q 05 FINAL 4 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
✓ 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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LIJ 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
o COMMENTS:
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IQ�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W 11CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
[7 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 site:
Inspector. 1 c- e-7C 47'
White Copy/Inspector's File Canary Copy/Site Notice