The URL can be used to link to this page

Home My WebLink About2009-00154 - sewer/water connect CITY OF ORONO PERMIT NO.: 2009-00154 . 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 04/14/2009 ' ` 952 249-4600 FAX: 952 249-4616 ADDRESS : 2680 SHADYWOOD RD PIN : 21-117-23-24-0046 LEGAL DESC : SHORE HILLS : LOT O15 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER PIPE 4" WATER PIPE 7"POLY W/V�'IRE APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 50.00 6501 CO. RD 15 MOUND,MN 55364 STATE SURCHARGE SEWER&WATER 0.50 (952)472-4959 S.A.C. 0.00 Minnesota State License#: 1804PM TOTAL 100.50 OWNER SEWALL,BARRY 2680 SHADYWOOD RD EXCELSIOR,MN 55331- 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 goveming 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 within 180 days of the date of issuance,or if consWction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsibl for suring all required inspections aze requested in conform e State Building Code.This permit may be revoked a ' e r e � / / / / pp ' ant Permitee Signature ate Issued By � ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED VE. � � . . ' FOR CiTY US�Q1�tI,lC O,¢0,�`O City of Orono I)aate Received; Permit# `r P.O.Box 66 2750 Kelley Parkway ❑In-House SAC Detemm�ation Form Corn�leted ; � , ; ..:.� Crystal Bay,MN 55323 ��op� (952)249-4600 Approved By(If Required}: CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aualication is receivedl GE�ER�L INFC1i�MATTt�i�T : 1. You may apply for urility 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 retiun 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. Urility connection pernuts may be issued to licensed contractors only. 6. Contact the Public Works Deparhnent(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 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. TYPE QF PERMTT ' (Check All'�'hat A 1 ) �Residential(May Require Approval) ❑ Commercial(Approval Required) �ew Connection ❑Addirional Connection ❑Re-Connection ❑Repairs ❑Disconnect Job Site I C)vvner Infc�rmation: � � N9d 1 �A�� Site Address: � , Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Cont�actor Informatian: ' , l i !� Contractor: S U�� w Contact Person: i��✓� ��c�'' ( � e Address: �� • !-S State License#: ;��0�? �D Of�jn�'! City: �� Zip 5�� Expiration Date: `2'3�� Phone: � ��o�`y�I S Alternate Phon�6 la ��' S�� S . � � r � ❑ SAC Charge(2009 Rate=$2,000.00) $ (SAC Charge must accompany all sewer permit applicarions unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) ��ewer Connection/Disconnect/Rep�r($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 d; copper �oLy �/�;'� 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADL"�TTT�NAL 1NFURMAT�QN-WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut. ■ 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: � � D TIME CITY OF ORONO CALLED IN -' INSPECTION NOTICE SCHEDULED � ' . 30 PERMIT NO. �� COMPLETED ADDRESS �� l' � OWNER CONTR. C/11��7!��ry�C ��(J TELEPHONENO. �� 7�� 77 9 � DESCRIPTION �� 71 � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL � LAKESHORE/WETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAI ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � ��IORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C01/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-460� OwnerlContractor on 'te: Inspector. White Copyllaspector's File Canary CopylSite Notice �� \�'� D TE TIME � CITY OF ORONO CALLED IN � � l� INSPECTION NOTICE SCHEDULED � = �C> PERMIT NO. �C��f�-f`:(')L��-� COMPLETED �' � ��GY7 ADDRESS l�g G S OWN E CONTR. TELEP N�NO.� I R � ^�,�-� � -� � � �� I�2b � DESCRIPTION �J 1- l�l� � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL, ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:�YES_NO � COMMENTS: 1E� 11� �k_ g_ I �s�j�l . � �,dLy�,SI��. l,�l;> � �l� �1�� I�o.n �1IrL._�.��1 �.�I� 0 � 0 � � � Q � f h �m� T � S rvl,� � � z W � W � j d W �'�VORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W��CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHtN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP OfiDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. � � � � �� White Copyllnspector's File Canary CopylSite Notice