HomeMy WebLinkAbout1997-009665 - sewer connection � PERMIT
'�ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ' .� r��
Crystal Bay, Minnesota 55323 Permit Number. �.=,:_,:M,L��
(612) 473-7357 Date Issued: _
SITE ADDRESS:
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _... ,. ... -: ' ;,;- _:,„ .. OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �
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t:,�ITY OF ORONO APPLICATION FOR UTILITY PERMITS �`'��
' Box 66 (2750 Kelley Pazkway) SEWERIWATER ��(t's � ' �
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Crystal Bay, MN 55323 ' , ,,:
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GENERAL INFORMATION � � �� �`� � � �,'',��:��
1. You may apply for utility permits by mail or in person at the City offices. ��. �x
2. Mailed in applications are subject to the postage and handling fees shown below. Permit cards will be sent by �`;;: , ,iQ
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 � ��"
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IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works !f �;
Department. Issuance of a permit does not grant this approval. ��
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7. All work must be done in accordance with State Code requirements. . ,�,_,
8. All work must be inspected before it is covered. Ca11473-7357. u�~:;� ��,���� ����
24 hour notice required. � , �,'°�_� ,� _ �' ,�`
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JOB SITE ADDRESS: � �� � M'
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Occupancy Type: Resid tial Commercial y
CQ T- t� Phone Number: L�7� ,��g� '�` �
Owner's Name: �
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Mailing Address: rrr- 0' City: ��v�.� 7�: ,�;��(o �'_�;�
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Contractor's Name: _`t PhoneNumber: T7� l�'( � �, .�
Mailing Address: /1 q��i ,�w��'�S' City: ,Lor� iG�a 7�p: 5�3;; '�. �
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PERMIT TYPE '� ' �
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Municipal Sewer Connection ($35.00 per stub) $ •_ }�.�
pipe size inches; material Schedule 40 air tested; cast iron �; } �
, �.;.
SAC Charge($950. 0)must accompany all sewer permit applications unless prepaid. If not prepaid, : ��
a sewer connection permit will not be issued. =�, �`�
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Municipal Water Connection ($35.00 per stub) $ �:� �" �k
pipe size inches; material copper; other <' � �
WATER METERS must be picked up and paid for at City Hall. �� " �
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(5/8" meters = $139.00; 3/4" meters = $191.00; 1" meters= $247.00) � "' � �'
- Separate Plumbing Permit issued for water meter. F �� �
Water meters must be set and sealed by Orono Water Department(473-735'�upon completion �� ��
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of ineter installation. = ��a
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REQUIRED minimum setbacks from drainfield and septic tanks=75' � `�� ��
REQUIRED setback from sewer line = 20' x �' � � _ � � ' ��
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PERMIT FEE CALCULATION ` � S�
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1. Subtotal of above permit requested $ 3 � �'
2. State Surchar�e $ .50 �' 'k '� �i
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The State Building Code Division Surcharge of$.50 per permit must be r � 'Y
included for each well,sewer and water connection permit requested. ' � k
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3. Postage & Handling(Only mail-in applications) $ 1.50 �} ,y ,' �
4. TOTAL PERMIT FEE (add lines 1-3 above) $ `' �` �?
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4. ,�
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do ' `x:
�`' all wark in strict accordance with the ordinances of the City and the regulations of the State of � �
t Minnesota, and certifies that all statements made on this application are complete, true and correct. '�
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' Signature of Applicant: � _i�t.�- �i���;�� Date: ��� :
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DATE TIME
CITY OF ORONO CALLED IN I�v2 /�' �7
INSPECTION NOTICEn / SCHEDULED r;r /� '���
PERMIT NO. 7 � ft�S^ COMPLETED /l
ADDRESS `�G'� �-�-u�- �tC
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OWNER � �-�esv CONTR.�z �2.�- �C _
TELEPHONE NO. �{ 7 �/ - /��% �/
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GFiA01NG/FILLINO
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANOS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 4 SEWER HOOK-UP 06 PROGRESS
F` 07 DEM�SITE 27 SEPTI . 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINC3 FINAL 28 CEDAR SHINGLES 36 FOUNDATION HEMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO G—
� COMMENTS:
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d C WORK SATISFACTORY:PROCEED
W - PROJECT COMPLETE
wL CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. -, pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR '- CITATION ISSUED
❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
Owner/Contra
Inspector.
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