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Home My WebLink About2014-01141 - sewer/water connect CITY OF ORONO * z 0 1 4 - 0 1 1 4 1 * � � 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 71 1 SANDSTONE CIR PIN : 33-118-23-i1-0045 LEGAL DESC : STONEBAY : LOT 042 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: WATER&SGWER CONNf?CTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 T&J CONCRETE WATER CONNECT/DISCONNECT/REPAIR 50.00 9100 BALTIMORE STREE7'NE STATE SURCHARGE SEWER& WATER 5.00 BLAINE, MN 5�449- TOTAL 105.00 (763)413-0988 Payment(s) Minnesota State License#: SW-6461 12,GENR-PB6461 12 CHECK 142�3 105.00 OWNER Stonebay Builders LLC 14870 BROCKTON LA DAYTON, MN 55327- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approvcd 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 addi[ional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied wi[h 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 construetion is suspended fi�r a period of I 80 days a[any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Coda This permit may be revoked at any timc for due cause. � � � � �� Applicant Permitee Signature Date Issu By Signature Date r �" . � FOR C1TY USE O1�TLY //,/� 4Z«N� City o[O�wno Date Received: Pemirt d1 " 7r A.O.Box 66 � 3750 Kelley Park�tiay ❑In-House SAC Determwahon Form Completed r ,� Crystal Bay.�dN 55323 .'�� ,.��`N (952)249-4600;Faa(952)349-4616 Approved By(I£Required): F1,�„�h CITY OF ORONU—SEWER& WATER/GENERAL PERMIT ('Note:Some permits may require appro�•al by the Buildung O�aal andlor Publu Warks Depa�Ymrnt') (ALL PERMITS- �Zav be snbiect M fnrt6er reciew aud mas•aot bo isxuad tv6ea the aoolicatioa is recair-ed) GENERAL INFORMATION ' 1. You may t�pply for utility pemuts by inail or in person at the City affices. 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by rehim mail within 2 business days. 3. Permits are not vAlld until yon receive a permit card. 4. Work mt�st not begin wiless the perinit ctud is avail�►ble on the job site. S. Utility conttection peimits 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 Al�'Y STREET AND DO NOT TAP Al\�MAIN without eapress Approvat of the Pabtfc Works DepArtmeut. Issuance of a permit does not grant this appro�•al. 7. All work m«st be done in accordance witli Staie Code requirements. $. All work must be inspected before it is covered. Call(952)249-4600,24+hoar notice��equii�ed. TYPE OF PERMIT Check All That A 1 �Residential(May Require Approval) ❑Commercial(Approval Recluired) (�New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water AvailaUility Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: '��1 S�1�n[�,t4�-bN-�. �1((�..�,C� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: � Q►� Cantact Person: 11�, �(�C6VY� V1�1Q5bn� 1 ►�G Address: Q)b0 �,�t w,D�tRr �1'�� State Licanse#: City: _ Zip:�q Expiration Date: Phone: �(03 -�13-6�1� Alternate Phone: L12--bg�-'�g� � �` ' . �. - r<- ❑SAC Chntge(2014 Rnte=52,485.00) $ (SAC Charge must accompany alt sewer permit applications unless prepaid) (Orono City Staff can deEermine if applicable) (If not prepAid,a sewer connecUon permit will not be iasaed) �Sewer Conaection/Disconnect/RepRir(S30i00/Per Stub) S Pipe size inches;material Schd 40 air tested; cast iron �f Connection/Disconnect/Repatr(SSO.OQ1Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑Water Av�ila6tUty For Fatnre Hook Up to R'ater(S50.00) $ WAter AvAilabilitv Exalan�tion: Contractor installed line to inside of house for future hook-up. This line wil!be inspected by the Public Works Department. Reauired Before Water Connection Petmit is Issued: 1. Issue Water Meter b'a Horn Pamit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Co�ect}�Q�Permit: 1. Collect Permit Fce&Issue Water Connection Pennit 1, SLIBTOTAL of Pamit Requested: � 2. STAT�SURCHARGE $ 5.00 3. POSTAGE&HANDLAVG(Only on Mail-In Applications) $ 2,pp 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) g ADLITF�O�TAL IlVF4R11�+I�TION—�ATER'METF.1tS • WATER METERS must be picked up and paid for at Orono City Hall,these aze on a separate permit. • WATER METERS mnst be set And sealed by Orouo Water DepAtrtment (952) 249-4600, upon completlon of inete.r instAflxtton. The undersigned hcreby applies to thc City of Oronv for issuance of a Utility Permit, agrees to do all work in strict accordanee with the ordinances of We City and the regularivns of Che State of Minuesota,and certifies tl�at all statements made on this application are,h ue aud coirect. . Applicant: "� Date: �D-lo-�O� � ✓ DATE TIME '- CITY OF ORONO CALLED IN �� INSPECTION NOT SCHEDULED / " — �'� PERMIT NO. �� COMPLEfED ADDRESS �I� �I G[.S�i�1� �,/_� � OWNER TELEPHONE NO. — '�`�� CONTRACTOR T�" J � DESCRIPTION � �� '�� • � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG Q ❑ POURED WALI ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB �WATER HOOK-UP ❑ PROGRESS � ❑ FINAL �SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z 01NNERICONTRACTOR TO MEET YOU:_YES_NO � y COMMENTS: � (� S� �� A (/ l' ��w-c✓ 5��r/i � WI� � /�� C � / � �"y / � h7 �i'J L/1`�' " �!'P.�I'I �i�C-��' , IN! � `�U� S-Zt�c'�r" S1L!`cJ/Ge O O /t i D�Izi S�+ L W/4 t�1'/r✓� w��1�/, �G`e �'.9��i� W � � (�!1�i � Q F+ 2 W �,Q// o � � J � �VIF�RK SATISFACTORY:PROCEED ❑PROJECT COMPLETE W O CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOMERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WFLL REfURN O STOP ORDEN POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: � � L ��'� Inspector: s�� White Copyllnspector's File Canary CopylSke Notics