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2017-00971 - sewer/water connect
` � CITY OF ORONO * 2 0 1 7 - 0 0 9 7 1 * 2750 KELLEY PARKWAY DATE ISSUED: 08/16/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 530 SANDHILL DR PIN : 33-118-23-24-0020 LEGAL DESC : ORONO PRESERVE : LOT 1 BLOCK 2 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW WATER AND SEWER CONNECTION � 1 � � APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 D.S.M. EXCAVATING WATERCONNECT/DISCONNECT/REPAIR 50.00 2916 ENTERPRISE AVE STATE SURCHARGE SEWER&WATER 1.00 HASTINGS,MN 55033- TOTAL 101.00 (651)480-1355 Payment(s) CREDIT CARD 5166 101.00 OWNER OPS Orono LLC 15250 WAYZATA BLVD#101 WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. — ' // ��� � � �� � � �� � l h � l 7 Applicant Permitee Signature Date Issued y Signature Date ��^\ FU I Y ll�i's ONI,Y ,C�� ����� City of Orono Date Received:� I'er�it N �I�� (/v � � '•, P.O.Box 66 � ` 2750 Kelley Parkway ❑In-Hoase SAC ination Form Com ed i s� ,Z-� Crystal Bay,MN 55323 � \\�is�io�-�'�` �952)249-4600/Fax(952)249-4616 Approved By(Ifittquired); CITY OF ORONO—SEWER&WATER/GENERAL PERNIIT (*Note:Some pe�mits may require approval by the Building Official and/or Public Worlcs Departroont•) (AI.L PERMi7�_ ]y�v be subiect to fi�+h�*�p�•�w and mav not be issaed when We aooli aK i� ;�-a� GEr�E��IIVFORIv4AT'IOI� 1. You may apply for utility permits by mail or in person at the City offices. 2. Mailed in applications aze subject to the postage and handling fee shown below. Permit cazds will be sent by retum mail within 2 business days. 3. Permits are not valid until yoa receive a permit card 4. Work must not begin unless the permit cazd is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600j for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without ezpress 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(952)249-4600,24+hour notice required. TYf'E dF PER�T Check All That A � (�f Residential(May Require Approval) ❑ Commercial(Approval Required) (� New Connecrion ❑Additional Connection ❑ Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connecrion For Future Hook-Up to Water Jo� Si#e/Ov�er In#'o�ation: Site Address: �30 5<IN1�N�u. G�-. Owner: ���� hV�[�.y �/�s, Mailing Address: City: Qi�4N6 Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ���,,/�I, �1',Ahr9`e���Gli►�C.. Contact Person: �i,�� �aL�/�„�i,� Address: / �� � State License#: City: .NL Zip: ��� Expiration Date: Phone: �is/, y8'D./3� Alternate Phone: �a/2� 9�9y�y� D�'�7�R�T�f'�':� , ❑SAC Charge(2015 Rate=52,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) (�J Sewe Conn�tio Disconnect/Repair($50.00/Per Stuti) $ Pipe size inches;material S�►yd Schd 40 air tested; cast iron �Water Connectio Disconnect/Repair($50.00/Per Stub) $ Pipe size /�� mches;material�Schd 40 sir tested; coppe�' ❑Water Availability For Future Hook Up to R'ater(�54.00) S Water Avaitabilftv�z�lanstlon: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. � Rec��ed Before Water Connection Permit is Issued: 1. Issue Water Meter&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water C�+*��►ection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: � 2. STATE SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATI03�1-�ATER METERS • WATER METERS must be picked up and paid for at Orono City Hall,these are on a�arate permit. • WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter installation. 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 tliat all statements made on this application are,true and correct. � �/�1/r�� Applicant: Date: _-.�`-'' — � . ��pqTE_I � TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE �/ SCHEDULED - -� � PERMIT NO.����� �C�/� OMPLETED • /'.30 �.'OZ� ADDRESS � +-� � OWNER TELEPHONE NO. ��-���-�3 CONTRACTO ���� � DESCRIPTION ��� � �� 41 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATI�N ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL ? OWNERICOI�fTRACTOR TO MEET YWJ:_YES_NO � y COMMENTS: `� � f S �i S u-��/'' �?,^ � ��� � �� � � 0 ,�` / � �J %�G� � � .ar t-eJ �/ �r,ai" ; � �( ��1 � �(��4.-�� U..� /� W � Q � � W � � ��WOFiK SATISFACTOFlY:PROCEED ��PROJ ECT COMPLETE W O CORRECT VMORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑(bRRECTUNSAFECONDITIONWITHIN NOURS. �pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca8 tor the next inspection 24 hours in advance. (952) 249-4600 OwnerlCor►tractor on site: S inspector: White CopYAnspector's File Canary CopYlSita Notice �� �'"�-:� '*�91� " � � .,,�, �� � ,, �,. � � -� , �� � - �.����� � �� � � ^�,-.,., ��. ' =��i!,. � i� � ... .�F��� M t �r � k � x +M�Y.. " � +S�,� . .. . * � ` �,�,, �`�� �'- �y i .� �� � �_' '�',� �'. � �$`� � a .. �.;� ,µ,. r��,�e' � �'# . � ^ ��� Y �' s * � � w�� f r"•`� ` �.. , ' � �', k�' � . • <: . 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