The URL can be used to link to this page

Home My WebLink About2017-01260 - sewer/water connect � ' CITY OF ORONO * z � 1 7 - � 1 z 6 � * 2750 KELLEY PARKWAY DATE ISSUED: 10/04/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 565 SANDHILL DR PIN : 33-118-23-24-0012 LEGAL DESC : ORONO PRESERVE : LOT 5 BLOCK 1 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER AND WATER CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 D.S.M. EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 2916 ENTERPRISE AVE HASTINGS,MN 55033- S.A.C. 0.00 (651)480-1355 TOTAL 101.00 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 goveming 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 l80 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. � ,� �% / � �-- � 1 U l `� l l/ Applic n Permitee Signature Date Iss d By Signature Date � . - R CI'1'Y il��OTTLI' g.�.^t�� City of Orono Date Receiaed: Pe�nit# ; P.O.Box 66 2750 Kelley Parkway �In-Ho�.se 3AC Determination Foim Completed ' ,�-� Crystal Bay,MN 55323 �`�(,�A�SHo¢�,t'� (952)249-46U0/Fax(952)249-4616 Approved By(I�'R�equ'ved): CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (*Note:Some peimits may require approval by the Building Official and/or Public Works Departrnent•) (ALL PERMITS- Mav be subiect to turther review and mav not be issaed when ffie aoolication is received) GEI�ERAi,INFORMATIOI� 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 fee shown below. Pemut cards will be sent by retuin mail within 2 business days. 3. Permits are not valid until you 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(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without eapress 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. TY�E OF PER�IiT Check All That A i �Residential(May Require Approval) ❑Commercial(Approval Required) �New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Jo� Si�e/Owr�er Infor�ation: Site Address: �� s�y��L '�'Q , Owner: � �D /'V�� . Mailing Address: c�ri: OQe�vo z�p: Home Phone: Alternate Phone: Contractor Information: Contractor: �-�..�. �;�R►�NL 1NG� Contact Person: /�� Xiei�✓�o Address: Zg�L ��,,iL �• State License#: City: ��•S Zip: s�3.3 Expiration Date: Phone: �5�1 �I86, /3�S Altemate Phone: ~ � D t�P�A�'i?'FEE�S ❑ SAC Charge(2015 Rate=$2,485.00) $ (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) [�Sewe Connection Disconnect/Repair($50.00/Per Stuti) $ Pipe size inches;material WL Schd 40 air tested; cast iron (�,Water Connection Disconnect/Repair($50.00/Per Stub) $ Pipe s�ze J_inches;material �I�dc Schd 40 air tested; copper ❑Water Availability For Future Hook Up to Water($50.00) $ Water Availabilitv Eznlanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. , Required Before Water Connection Permit is Issued: 1. Issue Water Meter&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection 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 INFORMATION-WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate 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 that all statements made on this application are,true and conect. Applicant: [Jw Date: �d��i�.�7 1 1P�, W � � .a � V �� /� � � �� \ � v � , . � � y �� S -�� '� s� � � S `I � %� � , � � --- � f - � � � � P r� �� f� / � � �-_ � -� x�y� a/�M ,� J \ ! �� S� J .� � ��J � X � � �� _ l � � � � � �� i v� _� �.- . �` � � r / _--...__.- � � ✓ '��v� �6 � �_ Daily S & W Install Sheet Date: Curb Box: Damaged/No Charge/New Extras&Notes: Contractor: List Parts Used: Address: City: Sand: Yes: No Rock: Yes: No Water:Copper Endo PexA Other: Size: 1.0" 1.25" 1.5"2.0"IPS CTS Sewer:SCH 40 Other: Cellcore Solidcore Size:4" 6" Air Test:Yes No Sump:Yes No Size: 3034 SDR35 Foot N/4ter: Foot Sewer: Foot Sump: Fittings �TY Fittings QTY Fittin s QTY Male Adapter CTS IPS Flare 22.5 22.5 Coupling CTS IPS Flare 22.5 ST 45 PacIPS X PacCTS Coupling 45 45 ST Pac X Female Flare 45ST 90 PacIPS X PacCTS Coupling 90 Coupler PacIPS X Flare Coupling Coupling WYE Ball Valve Sewer Adapter Cap Meter Valve WYE 6"x 4"Bushing Fusion Coupling Sewer Cap Fernco Siiver Solder Joint 6"x 4"Bushing Clean Out Cap Flare Nut Fernco Other: Curb Stop Pac/Flare Concrete Curb Box Clean out Cap Rod Fusion Coupling Other: Other: MAP: t i�' � , DATE TIME CITY OF ORONO cnLLED IN INSPECTION NOTICE SCHEDULED � ��_ PERMR NO. a'0� �� COMPL E ADDRESS�� n� O'WNER TELEPHONE NO. �� " - CONTRACTOR S � DESCRIPTION � � � � ❑ 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 � ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL �WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY �EWER HOOK-UP ❑ FOUNDATION/REMOVAL _ r ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OINNEIYr�NiRACTOR TO MEEi YWl:_rES_NO � COMMENT� � ��e � � 0 � If<sv.¢� �.�1 Gl1-6'�� c� � ° T��P�e��'s�_ � W OC ' Q F: W W � � � � K SATISFACTORY`.PROCEED O PROJECT COMPLETE W CORRECT WORK 6 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY 0 ❑CORqECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CdVERINd PERMANENT ❑(�RRECTUNSAFECAMDITIONWRHIN HOURS. �TOTAKEN INSPECTOR VYILL RETURN ❑STOP OF�ER POSTED.CAIL INSPECTOR �pTATION ISSUED O INSPECTION REQl11RED_CALL TO ARRAN(iE ACCESS. �;aq tor the next inspection 24 hours in advance. (952) 249-4600 Owne�lContractoronsite: �5� Inspector:� Whit�CopyAnspectors FIN Canary Copy181M Notice