HomeMy WebLinkAbout2004-P07664 - sewer connection PERMIT
�CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07664
Crystal Bay, Minnesota 55323 Pe�mit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 6/30/2004
SITE ADDRESS: 1435 Park Dr
Mound,MN 55364
P I D: 07-117-23-42-0020
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pemut Type: Sewer and Water Pernut Pernut Sub-type(s): Sewer Connecrion
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: ��'�''tt OWNER: James Marrinson
1530 280th Street W 1435 Park Dr
New Prague,MN 56071 Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PE EE SIGNATURE I SCJED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Aoplicant, 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1
+� - (Updated 1/5/04)
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC
Crystal Bay, MN 55323
GENERAL INFORiVIATION
1. You may apply for utility pernuts by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fee shown below. Pernut 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 pernut card is available on the job site.
5. Utility comiection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE 1N AN1'STREET AND
DO NOT TAP ANY MAIN�vithout express approval of the Public Works Department. Issuance of a pernut 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(952)249-4600, 24 hour notice required.
JOB SITE ADDRESS: �y-3,� �/•'� D���!"-Z� i����%�� i�%/�
Occupancy Type: _�Residential Commercial
Owner's Name: ���.,,�,. /J1�,r�",,,�z�„ Phone Number:
Mailing Address: City: Zip:
Contractor's Name: /� . �� � Phone Number: ,�'S"�2 -J�� --�2 %Q�'
Mailing Address: %.5'�Q 2�'D.Y�i �" �/�C� City:/J./ �i- ip: _��"p 7�
PERMIT TYPE �Connections ❑Repairs ❑Discorulect (Check One)
SAC Charge (2003 rate $1,350.00) $ (Set Rate)
Sac Charge must accoinpany all sewer permit applications unless prepaid.
(If not prepaid, a sewer connection will not be issued)
Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $
pipe size_�inches; material J� Schd 40 air tested; cast iron
Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at City Hall.
Water meters must be set and sealed by Orono Water Department
(952-249-4600) upon completion of ineter installation.
REQUIRED minimum setbacks from drain field and septic tanks= 75'
REQUIRED setback from sewer line =20'
PERMIT FEE CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50 (Minimum)
The State Building Code Division Surcharge of$.50 per pernut must be
included for each well,sewer and water connection permit requested.
3. Postage & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only)
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: Date:
�/ DATE TIM "
E
CITY OF ORONO CALLED IN
INSPECTION NOTI ��� SCHEDULED
PERMIT N0. D MPLETEO �2�`"��
ADDRESS � 3 � ���
OWNER CONTR.
TELEPHONE N0.
� DESCRIPTION �N�'^� ��Z -365' - 3 3c g �
� Oi FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER7FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUN�ATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
h COMMENTS:
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� RK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT YVORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL�NSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlConVacto
Inspector.
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