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2017-01263 - sewer repair
� � CITY OF ORONO * 2 0 1 7 — 0 1 2 6 3 * 2750 KELLEY PARKWAY DATE ISSUED: 10/05/2017 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2100 SHADYWOOD RD PIN : 17-117-23-31-0041 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 030 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : REPAIR NOTE: SEWER REPAIR APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 TRIPLE E WATER AND SEWER STATE SURCHARGE SEWER&WATER 1.00 5016 MITCHELL ROAD TOTAL 51.00 BIG LAKE,MN 55309- Payment(s) CREDIT CARD 4864 51.00 OWNER TAMTE,MICHEAL&MEGAN 2100 SHADYWOOD RD WAYZATA,MN 55391- AGREEMENT AND SWORI�t STATEMENT The work for which this permit is issued shall be performed acwrding to the approved plans and specifications,applicable City approvals,and the State Building Code. 1'his 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 governin�this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction suthorized 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 are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. • � �� ��-s- ,-� /� �5 /,7 icant Pe._ Date Issued Signature Date � / Y CI'Y`Y�—'�ONLY �0�0 City of Orono �ce 1t«xived: p�i� P.O.Box 66 2750 Kdley Parkway Q I�►-I�i�SAC DtterinineL�Form Completed a Crystal Bay,MN 55323 s�. , �,�k�sH o¢�, (952)249-4600/Fax(952)249-4616 App�ov�BY�'fte9u�: CITY OF ORONO—SEWER&WATER/GENERAL PERNIIT (•Note:Sane pamits maY re9uae appraval by the Building O�ccial aod/or Pub6c Works Departmp��•) ��.Z.p���$- Mtv be m6iect�n M.�h.r��sa.ew...r r..;.....a�,ti... ���_�e--"- GBAfERAi;INFO�IA�'I�l� . �.� ` . . . 1. You may apply for utilit}+p�amits by maii or in ptrsoa at the City offioes. 2. Mailed in applications are subject to the p�stage and handling fee shown bclow. Permit cards will � be sent by return mail within 2 business days. 3. Permits are aot valid nntil.yon rereive a permit card. 4. Work must not begin unless the permit card is available on the job site. 5. U�iility connec�ion permits may be issued to lfcensed cwati�ctors only. 6. Contact the Public Works Department(952-249-4600j for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN withont ezpress approval of the Publlc Works Departmen� Issuance of a permit dces not grant dris approvaL 7. All work must be done in accordance with Sta#e Code reqnirements. 8. All work must be inspected before it is covered. Ca11(952)249-4600,24+hour notice required, . TYPE�OF PER�IT � Ch�k.�11 That A: �Residential(MaY Require APPmval) ❑Comm�cia](Approval Required) ❑New Connection ❑Additional Connection ❑Re-Cannection ❑Repairs �Disco�� ❑ Water Availability Connection For Futur�Hook-Up to Water Jcc�v�b ��t�/Owper L�or�ation: Site Address: �/(�� ��;,a���.,�,�> C� - v�i 0��'= Mailing Address: . City: �p; Home Phone: Alternate Phone: Contrac�or Tii�ormation: r' L� G Contractor: r�1��-t. �wc�re�C��t�S� Contact Person: �r� � Address: '�`� r���nr/l Rd State License#: City: ��� l�e-G Zip:S'S3p9 Expiration Date: ��` �-� - �� Phone: ��3 �{7�-��i�t Alternate Phone: _��3-a O 7-� ��� .� . ` v .. . . , D�T����.�TCi�P�'�'FE� ❑SAC Charge(2015 Ratc=52,485.00) $ (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) �0 ❑Sewer Connection/Disconnect/Repair($SO.00Rer Stuli) S �� � pipe size inches;material�_Schd 40 air tested; cast uo ❑Water Connection/Disconnect/Repair($50.00/Per Stub) S Pipe size inches;materisl Schd 40 air tested; copPCr ❑Water Availability For Future Hook Up to Water(550.00) � Water Availabilitv Ezolanstion: Contractor installed line to inside of house for firture hook-up. This line will be inspected by the Public Works Department. � Required Before Water Connec�Qn Permit is Lssue.�i: 1. Issue Water Meter 8c Horn Permrt 2, Any Additional Connection Fees Paid(If Applicable) T��ue Water G�*��ection Pennit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: � 2. STATE SURCHARGE S 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,ADDITIONAL 1N�ORMATIO�T-R�ATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a�gparate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion o!meter installatiou. 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,trve and correct. Appli t: ,�. -- Date: ld- �- � � t -; � DATE TIME CITY OF ORONO CALLEO IN INSPECTION NOT CE SCHEDULED PERMIT NO.vZOI -D COI�IPLET D„ A��RESS o��0� �l�Y�wC�.^c`l� OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION �� � ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ 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 ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR T01M /�U:_YES_%% y COMMENTS: - � G' � � J��i�4� /` ,f��'�n � �'�'(�7 0 � � 0 W ' � � Q � 2 W � W � J W WORKSATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS.�pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CA�L INSPECTOR CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 4 hours in advance. (g52) 249-460� OvmerlContractor on site: � Inspector: �> �°�� White CopyAnspector's Ffle Canary CopylSite Notice /A �'�3"l� ,..,�.;�-�_ a ,. r i�1 � ' I a�d s t�� �� , ��� � .S�r.v �� � �. ��._ :� �� '�d.. r .� �� . � � . . .. , ��: .✓� , �d�„", nia '"'.... ... ;:. ����� � .n,��� �? _r�,. �,<;. �, � ,�b� ;. . , ,., ;„ ' ,_ �,. � $... ,� . �` ,1' y � , + � " � �'���i�� , � ¢ µ , E � � ,.. - .� . ��+a, ,� �+. _ # ;��, . . , �. �'4!` .+� , , . f � �. „ ... ,.» � . �,�, ry� � �. •'t" r���`�a�,�"�'�'`r" Y �'` ;,�� ,�!' k� . ��, , �.. .�.�. �, �� `� ���' '���=: ,� � . ��.. � - .� . . t:� r � ��;W� ":k'R.c '� �--.. r � R - . - .s.+ M• _<f_ � . x' 't�r'� , , ' . ,. - . . ' r � ' s� . �.-k .� . ,' f� t L � . . 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