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HomeMy WebLinkAbout2015-00137 - sewer/water connect CITY OF ORONO * z 0 1 5 - 0 0 1 3 7 * ' 2750 KELLEY PARKWAY DATE ISSUED: 02/02/2015 � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 675 SANDSTONE CIR PIN : 33-118-23-11-0040 LEGAL DESC : STONEBAY : LOT 037 BLOCK 001 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SAC PAID ON NEW HOME PERMIT#201401482-O1/26/15 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 J.S. STEWART COMPANIES STATE SURCHARGE SEWER&WATER 5.00 ll030 LAMONT AVE HANOVER,MN 55341 MAIL-IN FEE 2.00 (763)424-9030 TOTAL 107.00 Payment(s) CHECK 6086 107.00 OWIVER Stonebay Builders LLC 14870 BROCKTON LANE DAYTON,MN 55327- AGREEMENT AND SWORN STATEMEIVT The work for which this permit is issued shall be performed according ro 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[his type of work shall be compied with whether or not speciYied 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 ue requested in conformance with the State Building Code.This permit may be �, revoked at any time for due cause. �,/� �� �W vl �l `�1 �, /' �-�. � C��� �-� i il Applicant Permitee Signature Date [ssued By Signature Date ------- -"` FUR CiTY C�SE ONLY 'Q������1 City of Orono Date Received: _�__.,__, Pennit# P.O.13ox 66 LL �' ; � 2750 Keiley Parkway In-House SAC Determinatio��i�mpleted j S '��, �i Crystul Bey,MN 55323 � Pd �� ��.�Q� � � ��--t0 I � �^�"�' �'j''"r ,j�` (9.52)2A9-4600/Fnx(952)249-4616 Approved By(1�Required): � ^f�.� ri C1TY (JF ORONO—SEWER & WATER/GENERAL PERMIT (*Note:Some pemiits may require approval by the Building Oft"icial andior Pub:Sc V✓orks Depai'tment*j (ALL PERMI'FS- Mav be subieM to further review and ma�not be issued whea the anulication is received� GENERAL INF'ORMATION 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. Permit cards will be sent by return mail within 2 business days. 3. Permits are not valid until you receive a permit card. 4. Work must nat begin unless the pennit card is available on the job site. 5. Utility connection permits may be issued to licerised eontractors only. 6. Contact the Public Works Dcpartment(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET'AND DO NOT TAP ANY MAIN without express approval of the Public Warks llepartment. Issuance of a permit does not grant this approval. 7. All work must be dane in accordance with State Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required. TYPE OF PERMIT (Check All That Apply) � [_]Residential(May Require Approval) �]Cornmercial(Approval Required) (� New Connection [_]Additional Cannecti�n [� Re-Connection �f Repairs ❑ Disconnect [] Water Availability Connection F'or Future Hook-Up to Water Job Site/Owner Information: i Site Address: 4� 7 S SC�,r,���� �.�C.,��: ; Owner: �--'�vV�Q.,�aL'�t, �l�l.f �� MailingAddress: 1 ��' 7� ��1,��'YL�CL(,� City: �Jl•�-�i �� Zip: �S '.>Z 7 Home Phane:��� ��7� 1P�Z tp Alternate Phone: Contractor Inf'orrnation: � Contractor. °,� � C�4-�c/�u�'�C l,4 t;itiV Contact.Persan: �t�Q-c-,(-� Address: M ���l� t�;c.1/L(.Gl�l:� �'�1�'��`� State License#: City: �������'' Zip:��� Expiration Date: Phone: ��?)����'���U AlternatePhone: �«- ���" � �`� � DETERMII�IING PERMIT F'EES ❑SAC Charge(20i5 Rate=$2,485.00} $ (SAC Charge must accocnpany all sewer permit applicatians unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued} �Sewer Connection/Disconnect i Repair(�50.00/Pei•Stub) $ � � Pipe size�inches;material_�Schd 40 air tested; cast iron [�Water Cor^�^tion/Disconnect/Repair($50.00/Per Stub) $ � � Pipe size_.]__inches;materiat_ x Schd 40 air tested; copper ❑Water Availability For F'uture liook-Up to Water(550.U0) $ __ Water Avaitabilitv E�inlanation: Contractor installed line to inside of house for futw•e hook-up. This line will be inspected by the Public Works Department. Required Before VlWater Connectian Permit is Issued: 1. issue Water ivleter&Horn Permit 2. Any Additionai Connection Fees Paid(7f Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&issue Water Connection Permit LR� I. 5UBTOT'AL of Permit Requeszed: $ C G� 2. STA"I'�SUftCHARG�' � 5.00 3, PO5TAGE&HANDLING(Only on Mail-In Applications) $ 2.00 �Y2' 4. TOTAL P�:RMIT FEE(Add Lines 1-3 Above) $ �U � _�- �-- ADDITIONAL INFORMATION—WATER IVIETERS ■ WATER METERS must be picked up and paid for at Urono City Hall,these are on a senarate permit. ■ WATER METFRS must be set and sealed by Orono Water Department (952) 249-4600, upon completian of ineter installation. The undersigned hereby applies t the City of(�rono for issuance of a Utility Permit, agrees to do all work in strict.accordance wit ' �e ardinances of the City and the regulatians of the State of Minnesota, an ce�tifies that all s ernents made on this application are,true and correct. Applicant: � Date: � Z �' � � � ' '�" � . „� w.� `;,� qy" �h''�,,�'.�^.^ � yr " , 1 .� � _:�:. r.,� � � ��«-' ,:. i �'1 ,� �z ��'� � `'� � 14� �. � �� � �'' �' _ � "' ` _�`; �_�"�""�. �-w � . � �S` � ��'�/ �`' '� ,� :a--` _ � . . . . � � .' .a '. - "d".. � � x � Y� �/� C .I i �� �3�'���� �- � � � x�w �� . ., f: -' „e,.. ' � �� �� °', „� M+� ;,_ , . .� . ; 1 - : ` - ' L' 4 , ,' _ � . , w,� � ��.�� . 7 � , . � �� .,s�,.,� �. ; �„ =�. ° . t� 4 � N � l fr ,. .. .'- k' y R . � . � "�' �. z ; lj � / ♦ ,.r �.- �-�.-_ « �°" M;t�,� � �.- � ' . �- - . "` � -� " � . 'r' � '"` `"-�i'� � �„ ��r'< � � ,1 � � . �� _. Y I � �I • �{ �.: . t: l� Y , � +1. 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' 1��� � DATE TIME/ CITY OF ORONO LED IN �� INSPECTION NOTIC��y SCHEDULED l CZ�.� PERMIT NO�!`Y-��37 MPLETED ADDRESS �-S OWNER TELEPHONE N� " CONTRACTOR� S � DESCRIPTION �'�� ���i� - ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL �WATER HOOK-UP ❑ FOLLOW-UP W _ ❑ AS BUILT-SURVEY �SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL � OWNERICONTFiACTOR TO MEEf YOU:_YES_NO ! / � � COMMENTS: �'1 C S�Cl1 �� DU C � �J ��N a "��A C ��' �J �� � �:1�-wf=►' �V f �� � J o � � c�i�r�� s��� D l� 5� �G rN���i' 4��1�re 0 � Q �J�� �� /'� S'��, S �����e d, z �X�Q� �o� Q �, W � � � �� �r � , �,�e S ��► S�-e�er � a //�� W� �WORKSATISFACTORY:PROCEED �1 PROJECT COMPLEfE � \ � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C0IIERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (g52) 249-460� OwnedContractor on site: s � �"'y � Inspector. White Copyflnspector's File Canary CopyfSite Notice