HomeMy WebLinkAbout1995-007522 - sewer connection PERMIT
CITY OF ORONO � _... PERMIT TYPE: _-._ _ _ : : -.
2750 Kelley Parkway- P.O. Box 66 Permit Number: - ` ''°�=s"°�:�'f` �'`" `^�Y�
Crystal Bay, Minnesota 55323 . ��''
(612)473-7357 Date Issued: .
SITE ADDRESS:
:�:f;:�_ °=...-�;�=3; �_.._
� :,�;f,
i...'. '' :.,i : ;`;:..�_...� '' , 'f ^�(y—
��
DESCRIPTION:
:;�:;;;�-�, s-.- „�:��-�:-; _ _
'.:;w_'=?.��i' _. �>;:3�.}�j' :.. ;,.'�,'fi'9 I�...�. .. .^`t . _ `'�i�.3:�t'_3-. ! i_.�_i;•:,�:.�i_;._ �...�._u�`4�
- _ ...`?• ., _.�;t�;.� . ia�� c�•�:; i VC'°;;_ �z``. _�i_#�h!r^" �
REMARKS:
FEE SUMMARY:
'i_�1�:�' i-r+'��; :;y._'Z- ?_y t_:
� . � ._,._ ___. _ __ .
,_�1�t'i'�`E;::E"—'�'� _a'....�::f�
i l,l I.ri_, �'4�;?f� �..v_'_�.».�..._.��..L . _ ..
ti;-..—. :
CONTRACTOR: � � � - - -=�>�r� �y OWNER:
_ � . . _. _ . ,t_ L• i.:i.� .�.•,=%`? .. C. ���ti f. .,i_.. .
,-.,� _ ,- - -,-• -
' y��_Eh '.��._ . . _
` °=i
:_, s t-:y_�3.�;,F r;�, � t! r1fi� `=_ `.`_ a_+`.f.,tJE:� C.. _. —. �
.=,. . ,
I _.
, :.. '_, - —. _ , . : , _ ' ��.,,,
; ,�; �
� . . .
, ._ . _ ,. . ,... . , _
. . . . . , _ _ .
. . _ . . . ,_ . _i
, _ _ _
, . :
. . _ y' �{c�
>.. t• �E'S � i.� ^�.�.t. P;�`3^ .j �" �{ ,:^ _. . .. , .�`_'S;�1+_ . . . _. ; ., .E"aP�' € �s� �'e
. �
�:. �•
7
_
. . , o__ ...,.» . ._. _.. . .t.,_, .....�... . , ..,,.., .,:w w. . _.� � _ .. ��. . . �..��.,. i, . 1 _'i*,. ...... .
f e-
����_`�.�`I���Q` �l�� A;���.�°'? �"�.� t3f;� A�.:i_ _ _. . i�, .. # # `�� `' __, . '�_. ._ '.d�. . . . .�s:_�._ ' ' '�:�-"
i;��r��`��:� `�:��'�I�lt���:E: �t�€�.i ��;�'�T�` ��F � � . .. _°_. ..:�i.���,. x + r� F= ,x� �'�'
L � � � � �� � �� � .� � � � � �
���/ ,.,lma�-, �..�,
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APYLICATION FOR UTILITY PEItMITS
Box 66 (2750 Kelley Parkway) , _ . SEWER/WATER
Crystal Bay, MN 55323
GI;NLRAL 1NI'OI2MATION
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.
8. All work must be inspected before it is covered. Call 473-7357.
24 hour notice required.
JOB SITE ADDRESS• ��'� ��-� -� _-1�
Occupancy Type: v� " Resident�tI Commercial
Owner's Name: ��J � '" � �_-•� PhoneNumber: =-��' - �, -- -=-� ���/
Mailing Address: '-��'S' �� City: 7�p:
Contractor's Name: � �,:y� „ � - PhoneNumber: �y__,�� ,��� ��—
Mailing Address:%� � �� City:��,���. 7�p: �;�� ��—
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $ �'�'� �� ` _
�.��-;
pipe size <-�' inches; materiak��,/� �pVC (on sand fill); cast iron
SAC Charge ($850.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipat Water Connectioii ($35.00 per stub) $
pipe size inches; material copper; odler
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 inust be set and sealed by Orono Water Department (473-7357) upon
completion of ineter installation.
R�QUIRED 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 Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per perniit must be
included for each well, sewer and water coimection permit requested.
3. Posta�e & 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.
/ .
�
� �.,lG� i-��� � Date: /i —i�- ,�� ;--
Signature of Applicant: �t�il�i
DATE TIME
CITY OF ORONO CALLED IN ��-/S'�S �a%�l���
INSPECTION NOTICE ) SCHEDULED //'/S- 7�S' a•'30��
PERMIT NO. �i �J� �"" COMPLETED �
ADDRESS ��S ����� � � :-_i'�'�' �JX-�z����� ' �.
OWNER CONTR.�.C�..�..��rzl1/LJ
TELEPHONE N0.
� DESCRIPTION
� 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 OS FINAL 14 SEWER HOOK— �LP� 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAfNT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
J
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
j
d
� �WORKSATISFACTORY:PROCEED ROJECTCOMPLETE
W ❑ CORRECT WORK 8,PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r-, pHOTO TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP OFDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContract n te:
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice