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Home My WebLink About2008-00301 - sewer connect � :� CITY OF ORONO PERMIT NO.: 2oos-oo3o� 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 10/15/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 1950 SHORELINE DR PIN : 10-117-23-42-0012 LEGAL DESC : ORA PARK ON LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 35.00 WESTONKA SEWER&WATER STATE SURCHARGE SEWER&WATER 0.50 6501 CO.RD 15 MOLJND,MN 55364 TOTAL 35.50 (952)472-4959 Minnesota State License#: 1804PM OWNER CORNEJO,MARIA 1950 SHORELINE DR WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this pertnit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for oniy the work described and dces not grant pertnission for additional or related work which requires separate pertnits. All provisions of laws and ordinances governing this type of work shail be compied with whether or not specified herein.This permit will expire and become null and void if consVuction 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 are requested in conformance with the State Building Code.This permit may be revoked at y time for se. � �� i i A p cant Pe ee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. J � _ ��UR�1'�'3l`it5��`()NT,�1I�` ;: �.._' �,¢�� City of Orono �aYe��ece�ve�; Peinvt# _�,�,;� P.O.Box 66 '� `_ � �� 2750 Kelley Parkway ��Iti I3ouse St�Determivation�'o�m+Coi�7eted;�; � $ �,�,r� Crystal Bay,MN 55323 , ��. � �; ��a�� (952)249-4600 .�P�prbvecl B3��(�"�Requirecij�,� � ' 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 auolication is receivedl ' ��LLu�':, Y Z'`::L`1�� e�'. "4 �'" q �' y #5 d r? .�' `�j,-� d" 1 �,t ' �� 7, i+ 1. You may apply for utility pernuts 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 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 accordance with State Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required. �'��':��E��1� �� ' �; � (��l T�.t.�� '�;>��` ;� , �- �Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection �Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect :70� �te!=C�vner�tm�foz�at�on. �- Site Address: �� fl/� `�� /?/�. Owner: � ��1� Vt't�C�os�� Mailing Address: J�"" � City: Zip: Home Phone: Alternate Phone: Cc��trac'tor�n�'orm�.tic��, c Contractor: 1.��(� S Contact Person: �� C �c/�� Address: �� . � �� State License#: �g�`�� City: �Q�� Zip:S'�'36Y Expiration Date: f 2 -3�� Phone: C��'a \'��` Y�l�� Alternate Phone: C 6�� y�'S 7�� I � ❑ SAC Charge(2008 Rate=$1,825.00) $ (SAC Charge must accompany all sewer perxnit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) ❑ Sewer Connection/Disconnect/Rep ' ($35.00/Per Stub) $ Pipe size�inches;material�Schd 40 air test�d; cast iron ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ , � �I'�',�5` � °.�'��.t'.1��'` -��`�E��RS �'t .;� ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate nermit. ■ 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 e n this application are,true and correct. � Applicant: Date: ��—(j�O � �J� �-� ✓ CITY OF ORONO CALLED IN � ` AT 0� TIME �—_ INSPECTION TIC SCHEDULED ` ��__ a� �Q PERMIT NO.��'�d� COMPLETED � ADDRESS 0�� ✓I� �r CN 1 OWNER CONTR. J w TELEPHONE NO. f:��l/�h % S a- T 7�_'"��`Sy � DESCRIPTION �� LLY�n � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLIN Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLA S y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ 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 i ❑ PLUMBING fil ❑ SEPTIC FINAL ❑ WARD COVER REMOVAL � ❑ PLUMBING FINA� ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO v�i COMMENTS: � W C o � � T�S-f- / 'S M' .� • � � ° ��•�� S -E- � u v,�,c' �-��-��rP ..'{7 W � Q � Z W � W � � � W �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE �+ ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY. W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR 1MLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on s' : Inspector. White Copyllnspector's File Canary CopylSite Notice