HomeMy WebLinkAbout2010-00546 - sewer repair CITY OF ORONO PERMIT NO.: 2oiaoosa6
' � 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 07/OU2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1610 SHADYWOOD RD
PIN : 17-117-23-21-0010
LEGAL DESC : SHADY-WOOD
: LOT 000 BLOCK 000
PERMIT TYPE : SEWER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : REPAIR
NOTE: SEWER REPAIR
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00
PIPELINE IND STATE SURCHARGE SEWER&WATER 5.00
2270 CAPP RD
SAINT PAUL,MN 55108- TOTAL 55.00
(651)645-0622
OWNER
ROGERS,D&G
1610 SHADYWOOD RD
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 sepazate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.l'his permit will
expire and become null and void if conswction 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 aze
requested in conformance with the State Building Code.This permit may be
revoked time for du
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Applicant Permitee Sig Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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CITY OF ORONO—SEWER& WATER/GENERAL PERMIT
(*Note:Some permits may require approval by the Building Official and/or Public Works Deparhnent*)
(ALL PERMTTS- Mav be subiect to further review and mav not be issued when the annlicstion is receivedl
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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 perxnits may be issued to licensed conlractors only.
6. Contact the Public Works Department(952-249-4600)for urility 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.
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�Residential(May Require Approval) ❑Commercial(Approval Required)
❑ New Connection ❑Additional Connection ❑Re-Connecrion �epairs ❑Disconnect
❑ Water Availability Connecrion For Future Ho p to Water
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Site Address: �G 1(') �nacr�y �,{)�,�� �.�. r,(
Owner: Gcx� I ��,(cr P,U- Mailing Address:
City: �)l�p Zip:
Home Phone: _9��Z —�7'/9'Z// Alternate Phone:
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Contractor: N�O• Contact Person: �5�-
Address: �7��� .,eb � , State License#:
City: � ( Zip:`�51 (y Expiration Date:
Phone: ��(�y��z Alternate Phone:
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❑ SAC Charge(2010 Rate=$2,100.00) $
(SAC Charge must accompany all sewer permit applicarions unless prepaid)
(Orono City Staff can deternune 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 au tested; copper
❑ Water Availability For Future Hook-Up to Water($50.00) $
Water Availabilitv Ezulanation:
Contractor installed line to inside of house for future hook-up.
This line will be inspected by the Public Works Department.
Required Before Water Connecrion 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 $ 5.00
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
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■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate 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: 7� 'Z� I�
Monica Fadness
From: do not_reply@korterraweb.com
Sent: Thursday, July 01, 2010 11:17 AM
To: Scott Oberaigner; Don Debaere; Monica Fadness
Subject: Herald Server Message for ORONO/EMERGENCY
Importance: High
EMERGENCY TICKET: 100305493
Address: 1610 SHADYWOOD ROAD, WAYZATA CITY Near Intersection: NORTH SHORE DR Done For:
PIPELINE INDUSTRY/HOMEOWNER
Company: PIPELINE INDUSTRY
Contact: JESSIE WAKEHAM Phone: (651)645-0622
EMERGENCY REPAIR OF SAINTARY SEWER SERVICE
WTB: 07/01/2010 11:20:00.000
1
�J DAT TIME �
CITY OF ORONO CALLED IN ! ��
INSPECTION NOTICE/,,,s��[� SCHEDULED ��
PERMIT NO.o��l��wV L� OMPLETED
ADDRESS ��P�� G1lC�4`GGC.�
OWNER � �ELEP ONE NO.
CONTRACTOR �'
>; DESCRIPTION C��_
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� ❑ FOOTING ❑ PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y O FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWE OOK-UP ❑ COMPLAINT
� O DEMO-SITE �� MC MAINT. ❑ FOLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W{LL RETURN ❑ CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
O INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-4600
OwnerlContractor on site:
Inspector.�sn
White Copyllnspector's File Canary CopylSite Notice