HomeMy WebLinkAbout2008-00297 - sewer/water disconnect CITY OF ORONO PERMIT NO.: 2oos-oo29�
., 2750 KELLEY PARKWAY
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' ORONO, MN 55356- DATE ISSUED: 10/14/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 2259 SHADYWOOD RD
PIN : 17-117-23-43-0127
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 001 BLOCK 002
PERMIT TYPE : SEWER&WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DISCONNECTiON
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 35.00
PETE'S WATER& SEWER, INC. WATER CONNECT/DISCONNECT/REPAIR 35.00
800 LOWRY AVE NE
MINNEAPOLIS, MN 55418- STATE SURCHARGE SEWER&WATER 0.50
(612)789-6162 TOTAL 70.50
OWNER
NO KNOWN OWNER
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.This permit will
expire and become null and void if construction a�thorized is not
commenced within 18(Ydays of the da[e of issuance,or if construction is
suspended for a peKi6d of 180 days at any time after work has commenced.
The applicant isresponsible.for assuring a�l-t�quired inspections are
requested in c,dnformance with th Stat�uilding Code.This permit may be
reva ed at�E time for due ca e
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p i er � e ignature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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�,�p�,� City of Orono �at,�F.ece�a� Pei�niit# � ° �'
P.O.Box 66 �; : �: �� � ; -
2750 Kelley Parkway �=1n�3ause SAiC Detei�saination Fcari�l Completed �
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CITY OF ORONO—SEWER&WATER/GENERAL PERMIT
(*Note:Some pecmits may require approval by the Building Official and/or Public Works Department'") _
(ALL PERMITS- Mav be subiect to furthec review and mav not bd issued when the aoolication is receivedl -
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1. You may apply for utility pernrits 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. Worle must not begin unless the pernut 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 ezpress
approval of the Public Works Department. Issuance of a pernut 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-Connection ❑Repairs �Disconnect
Job Sit�;:l C3�er Infcix�a#cin: '
Site Address: c7�as 9 �I�'�_�,tJ�� 0•'-�/.
Owner: Mailing Address:
City: (Ji'�f'l/� Zip: �53�,7-�
Home Phone: Alternate Phone:
Cc���ractor 3�for�natio�: `
Contractor: � -tC � ✓f�ontact Person: °��/��
Address: c.C,rJ �,r w�.> ,�¢.(� IU• £. State License#: ���
City: ��� . Zip:��/�Expiration Date:
Phone: �/2�j�'-lp/l��,._- Alternate Phone: �i� 3�3- y�3 9
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❑SAC Charge(2008 Rate=$1,825.00) $
(SAC Charge must accompany all sewer pemut applications unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid,a sewer connection permit will not be issued)
❑ Sewer Connectio /Disconnect Repair($35.00/Per Stub) $
Pipe size in , al Schd 40 air tested; cast iron
❑Water Connection/ isconnect Repair($35.00/Per Stub) $
Pipe size inches;ma nal Schd 40 air tested; copper
1. SUBTOTAL of Pernvt Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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 s aratepernut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation. .
The undersigned hereby applies t e City of Orono for issuance of a Utility Permit,agrees to do
all work in strict acco anc�'with t ord' ces of the City and the regulations of the State of
Minnesota,and ce ' �tat all st eme " made on this application are,true and correct.
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Applicant: � Iaate: �
` . DATE_ TIME V
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CITY OF ORONO �_ CALLED IN �L I
INSPECTION NOTIC � SCHEDULED �L�-�� � � b
PERMIT NO.c������'�1COMPLETED
ADDRESS �� �J � S �'1C<C�P �AX �
OWNER CONTR. ���CO_<<l ��I�
TELEPHONE N0. `� � �� � � �fl I �n Z � �`'��
� DESCRIPTION \'D Lt �11 �j .�,(�1'11�4�'�
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
� ❑ WALL BD.
Z ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPIAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINA� ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIOtJ RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on s� e:
Inspector. l.�!� � �
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