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Home My WebLink About2014-00914 - dewer/water disconnect ' " , CITY OF ORONO * 2 0 1 4 — 0 0 9 1 4 * 2750 KELLEY PARKWAY DATE ISSUED: 08/19/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1645 SHADYWOOD RD PIN : 17-117-23-22-0013 LECAL DESC : UNPLATTED 17 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER& WATER 5.00 J P SCHMITZ CONSTRUCTION COMPANY LL WATER CONNECT/DISCONNECT/REPAIR 50.00 16450 1 l7TH AVE N TOTAL 105.00 MAPLE GROVE, MN 55369- Payment(s) CHECK 11650 55.00 CHECK 11650 50.00 OWNER LANDSOURCE 550 25TH AVE N ST CLOUD, MN 56301- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State f3uilding Code. 't'his permit is for only the work described and does nof 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 nol 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 construction is suspended for a period of 180 days at any time after work has commenced. I he applicant is responsible for assuring alI required inspections are rcquested in confori an i l e State Building Code.This permit may be revoked at an im du caus - _._ - /�Za ��i, � � °°�C��- � � l`' � < Applicant Permitee � re Date � Issued By Signature Date - FOR CITY USE ONLY i''�\,. • ,yr.q��--��1„��-'r Clty Of�TOnO Date Received: Permit# !( `'� `C P.O.Box 66 � � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �� , Crystal Bay,MN 55323 k '�`'1 . � (952)249-4600/Fa�c(952)249-4616 Approved By(If Required): � CITY OF ORONO— SEWER & WATER/ GENERAL PERMIT (*Note:Soine permits may require approval by the Building Official and/or Public W orks DepartmenY*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the application is received) GENERAL INFORMATION L 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 retum 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 accardance 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) ❑New Connection ❑ Additional Connection ❑ Re-Connection ❑Repairs isconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: / �1�� 17�� Owner:��(� /'��C�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor�-� '��u'T��1�%(�L<<� ContactPerson: ��V Address:�� J� State License#: City:��'��U=� ��t'L��G% Zip�� Expiration Date: Phone:7��`��rW�'` l ( �� Alternate Phone: DETERMINING PERMIT 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 connecfion permit will not be issued) �.Sewer Connecti �sco c /Repair($50.00/Per Stub) $ Pipe size inc es;material Schd 40 air tested; cast iron �]Water Connection is Repair($50.00/Per Stub) $ � Pipe size in , ateria] Schd 40 air tested; copper ❑Water Availability For Future Hook-tip to Water($50.00) $ Water Availabiliri�Explanation: 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&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Coliect 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) $ ADDITIONAL INFORMATION-WATER METERS ■ 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 b}� 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 accorda ce �th the ordinances of the City and the regulations of the State of Minnesota, and certifie t t 11 s atements made on this application are,true and correct. Applicant: Date: � ��-- ✓ TE TIME CITY OF ORONO CALLED IN ==j� INSPECTION � _� Q� SCHEDULED � �Q• �J PERMIT NO 7 OMPLETED ADDRESS � �� OWNER T�L HONE NO. 3��7��2 CONTRACTO �� DESCRIPTION N S � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP � PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL � ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS:��PiY'�- W �-� r�� SCC rin�P G f" ' � ^�/�,� � J O � � O W � Q � � W � � ��WORK SATISFACTORY`.PROCEED O PROJ ECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOA/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN INSPECTOR WILL REfURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: � Inspector. White Copyllnspector's File Canary CopylSite Notiee