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Home My WebLink About2014-00538 - sewer/water connect ,� �" CITY OF ORONO 2750 KELLEY PARKWAY * 2 P1 1 4 - P1 0 5 3 8 * DATE ISSUED: 06/02/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2524 SANDSTONE LA PIN : 33-118-23-11-OO19 LEGAL DESC : STONEBAY : LOT 016 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 BOLLIG & SONS, INC. STATE SURCHARGE SEWER& WATER 5.00 1 1401 COUNTY ROAD 3 TOTAL 105.00 HOPKINS, MN (612)938-4433 Payment(s) CHECK 8719 ]05.00 OWNER Stonebrook Homes 1016 COVETRY PL ED1NA, MN 55424- 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 gran[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 wi[hin 180 days of the date of issuance,or if construction is suspended Yor 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. �-z - (�-% � � pplicant Permitee Signature Date Issued By i ature Date . �l� A FOR CITY USE ONLY � 1.��- Date Received: Pemut# ��-��- �� City of Orono I` � P.O.Box 66 � ,p � 2750 F:elley Parkway ❑In-House SAC Determination Forni Completed �,�.�E � , \`/ Crystal Bay,MN 55323 �' � _�'��'\ (952)249-4600/Fax(952)249-4616 Approved By(If Required): �.�,.�.��r, CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT (*Note:Some permiu may require approval by the Building Official and/or Public Works Department*) (ALL PERMTTS- Mav be subiect to further review and mav not be issued when the application is received) GENERAL 1NFORMATION 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 not begin unless the permit card 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 express 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. TYPE OF PERMIT (Check All That A 1 ) ❑Residential (May Require Approval) ❑Commercial(Approval Required) �ew Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: � ��`� � �.4�V'� ��- ��'�' � � �, � ��'-� Mailin Address: ��`'�� -` � ��'�' Owner: `�N�ci v r g City: �`�= Zip: Home Phone: �S�Z- 3`�lS` -G�G� Alternate Phone: Contractor Information: Contractor: ��C�C � ��" Contact Person: �--�i�"� ��``��`'— pQ (�cy'-�'73 l.� G 3� Address: (lYG( Cc; ��- � State License#: � j z -3l�ls�-- City: 7�A�� Zip:-5��4�) Expiration Date: . Phone: `!SZ- 93�-`�L33 Alternate Phone: � ,� DET'ERtuIINING�ERMIT FEES ❑SAC Charge(2014 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) ❑Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exalanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Reguired Before Water Connection Permit is Issued: 1. Issue Water Meter&Hom 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 $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIOI�TAL 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 correct. Applicant: Date: r � � V D� �E TIME CITY OF ORONO CALLED IN ___1�.f1�Y INSPECTION TIC y�� CHEDULED - ' PERMIT N�� -��v�� PLETED � ,�_, ADDRESS � � � OWNER TELEPHONE NO. �- 5��7 � CONTRACTO � � � � DESCRIPTION G�_ � ��-C/Z... � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADiNG/FILLING Q ❑ POUFED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANOS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ATER HOOK-UP ❑ PROGRESS ,` � ❑ FINAL �SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: -�' S � 2 - d�� W ,/�� a Y U C ..� C� C�' �`- 2 .Wr� � J O / ,/ f � L `( � � �7' W/�1��'e '��(JV C'' Cl/'� ��`O W .� �l�r�� .� t�u i� �"�r�r t.c.r.i� . � Q � �� e z � � � � � , ,.� .� ,�� W �WORKSATISFACTORY:PROCEED ,., -� ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED��' ^ ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR AEtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED � ❑STOP ORDER POSTED.CALL INSPE�,QR O INSPECTION REQUIRED.CALL TO ARRANfaE ACCESS.� ,� . ;i � �� Call for the next inspection 24 hours in advance. (g52) 2� OwnerlContractor on site: ,- "� Inspector. `� White Copyllnspector's File Canary CopylSite Notice � ,,,