HomeMy WebLinkAbout2003-P06777 - sewer/water connections _ '"� PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PQ Box 66 P06777
Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit
(952) 249-4600 Date Issued: 9/18/2003
SITE ADDRESS: 2$00 Pheasant Rd
Excelsiar,MN55331
P I D: 21-117-23-3 2-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Pemut
Permit Sub-type(s): Sewer&Water Connections
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Perniit Fee: $ 70.00
Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 70.50
APPLICANT: Thompson Plumbing OWNER: James&James Echtenkamp
15001 Minnetonka Ind.Rd. 120 Birch Bluff Rd
Minnetonka,MN 55345 Tonka Bay,MN 55331
THE LJNDERSIGNED 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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AP ANT PE E SI(3NATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required),1-Auplicant 1-Monthlv Reuorts, 1-Assessin¢, 1-Finance Page 1
' i-04-2001 12:4dpm Prom-CITY OF ORONO +0522404616 T-2oT P.001/001 f-305
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CITY OF ORONO A.PPLiCATYON FUR UTILTTY PER.MTTS
BoY Gd(2750 KaUey Parkway) SEWER/WATER
Crystal Bay,MN 55323
CEN L II�IFORMAT�QN
1. You mey sppty for�atility paemiu by mall or ui persan atthe City officea
2. Mailed tn applications are subject to the postage and han�ing fee showa below. Permit cards will be sent by
return mnil tbt same day the applieation Is rocuivad,
3, Pecmits are aot vaJid until yoa roo�fve a petmit esrd.
� 4. Wa�ic must not begin unlesa�e pemilt card la avail8ble aa the job site.
S. Utility connxtion pennits may be issued to licens�d cantractors only.
� 6. Coatact the Public Works Departmeat (95?-249�600) for uu'liry swb bs-built locations. pQ NOT
QCCAVAT'8 IN ANY S'IREET AND DO NC�T TAP ANY MAIN witho�t express approval of the Public
Warks Departmea� [ssuanca of a perm�t does not�ant this npproval.
7. AR wo�k muat be deae in accorc�ncce with Stm e Code roquireiueats.
, H. AA wark must bc enspocted b�fore it is covera f. Gdl(452)249-4b00.
24 hour notiee req�ired.
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.roa sr�`��nnpx�ss: -��'v�`�` �'h���:���, ���?��;-�.,�'�
Occupaucy'I�pe: k Rrsidentiat Commerciai
OVvuer'R 1�Is�C; =�c�<••�---� ���n`.'-���=�� ,k�,�,.�,�=�,' Phoae Number:
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Maili.n�Atidre��:.i_�zr,,+-�.�,a-, �,�,a.�����--�� • Cityc�. = T�x 4�5-��►
Contractor'aNa�e� �;t � •. C , PLaacNumber:`l� - � _ �, 'l i
MsilingAddras:.1SC'i •\ [ _ ��i'�1��:'� - 1�'i¢ CI�/:�~��,,�1 ifktC..1M(o. �t�-'�---�1-1`
P��T TYP�
Munictpal Sewer Conncction (S35A�per stub} $ ��_� , CC: �
1/���� pipe size�_inches; material,,,�„Schedule 44 air tested; cast iron
�""'�' SAC Chnrge(2400 rate$1,150.Q0}must acco�pan�aIl sewtr ptrmit applications unless prepaid
�� r If not prepaid,a aewer connection permit will�wt bc issued.
Municipal'I�Ater Connection{�35.00 per stub) $ ����v
pipe aiu�,�-t inches: matcrial��,,,.copper; other
WATER METERS must be pick,ed up and paii!for at City Hall.
R'ater metera mast be act and sealed by (lrono Water Depar�m�nt (952-?A9-4600) apon
compledon of inet�r InstxUsttion.
REQU�minimum satbacks from drdin field and septic t�nks=75'
REQCJrYR�D sctb8ck$om sewer line=�0' ,
PF��FE�AL�IILAT14rt
l. 3ubtotal of abovc perinit roqucstcd $ `�1 E`:�_(��
2. S�ts.�z�..-�c�ze $ .50
Tbe State Huilding Code Divts�n SurehaTge oi�.SO per perrnit must be
�aoluded for eaari well,sewor and watar conaa�3ion permit requrstecL
3. Pastage.&�andli�g(Only mail-in applications) � ��
4. TOTA.L PERNIIT FEE(ndd linos 1-3 above) � '1 f�. �
The undersigacd hereby applics to the City of�hono for issuancx af a Utility Permi�,agrecs to do
Sll wosic in SittiCt exord�ct with thc ardinan�:es of the Cifiy and tbe re�ulations of the State of
Minncsota.and certifies that all statements tnadc on this�a�plicatioa ere complete,�ue and correct.
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�ignat�ue af Applicacrt�_ / ����,� � ; '�.�u���i Da�e: �- /�� �C� _
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