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2015-00710 - water connection
+ CITY OF ORONO * 2 0 1 5 - v� 0 7 1 v� * `� 2750 KELLEY PARKWAY DATE ISSUED: 06/04/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3425 SHORELINE DR PIN : 20-117-23-12-0034 LEGAL DESC : REG.LAND SURVEY NO. 1422 : LOT 000 BLOCK 000 PERMIT TYPE : WATER PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : CONNECTION NOTE: NEW WATER CONNECTION � APPLICANT _..�v�CT/DISCONNECT/REPAIR 50.00 �1'ATE SURCHARGE SEWER&WATER 5.00 PETE'S WATER& SEWER, INC. 800 LOWRY AVE NE TOTAL 55.00 MINNEAPOLIS, MN 55418- Payment(s) (612)789-6162 CREDIT CARD 5380 55.00 OWNER Brook Investment Group LLC 34321 MYRTLE LA LJNION CITY,CA 94587- 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 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time r due cause. � ___---�'—� -- _ �� � ,� /S -/ i 7� i _ pplicant Permi ��gnature__.__— Date Issued y ignature Date ti Fd CI'1' 'EONLY��y /}� , J$-���',, City of Orono Dace tteceiv��t �Perm;t#o�[J f � civ 7�Q � P.O.Box 66 � f� 2750 Kelley Pazkway ❑In-Iiau�e SAG Detertnination Form Completed �f Crystal Bay,MN 55323 �������j' (952)249-4600/Fax(952)249-4616 t�pproutd By(If Requiredji CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building O�cial and/or Public Works Department') (ALL PERMITS- Mav be subiect to turther review and mav not be issued when the aoolication is received) GENERAL�iF'f)RMATIDN 1. 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 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 NaT 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 noNce required. TYPE UF PERMIT CheckAll'�'hatA' 1 ❑Residential(May Require Approval) �Commercial(Approval Required) ❑New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site!Ow�ner Infarmatic�n: SltB E�(�dY'eSS: 3425 Shorline Drive OWriet:sadiq punjani/irfan habib Malllrig Ad�T'eSS: 1337 Mound Trail City: Centerville Zlp: 55038 Home Phone: s�z-aso-s�s� Alternate Phone: Ccantractar Infarrnatian: ` Meyer Companies,Inc. COritTSCtOT': DBA Pete's Water 8 Sewer CO11t3Ct Pe1'SOri: Lee Meyer ACICICeSS: 2316 Jefferson St NE State L1CeriSe#: PC689875 Cl�: Minneapolis Zjp; 55418 EX]711'1t1017 Date: 12/31l15 Phone: s�2-a�a-o»� Alternate Phone: s�2-a�a-o»� � � �� t�ETERMINFNG PERMIT FEES � ���� �� ❑SAC Charge(2015 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono Ciry Staff can determine if applicable) (if not prepaid,a sewer connection permit will not be issued) ❑Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast iron ❑X Water Connection/Disconnect/Repair($50.00/Per Stub) $ 50.00 Pipe size�inches;materialductile Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Required Before Waler Connection Permit is Issued: 1. Issue Water Meter&�Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ 50.00 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ -�:�-� 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �—' ��. OZ� ADDITIONAL INFORMATION—WATE& METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pennit. ■ 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. 7 ; Applicant: Date: si2i�s � ����i'�� .� ;� � t: . � � t ` w i a �� °'1R" �',��+�� �� i�', �'h �� �'`�� � �� ., .,.�'� i f+� ' - ��a�,� '�,�' �� I ^���I�I �� �,��- �r��•• ,�, c a � 7�r4�,� �j�, ;'d t��4 ����� 1 r�`It, . �5.+s 'y�,..� �- �:�6 �'s=� e n• � ' � � �� i� � �t. _ { i y r � j � �, 1 . �'i . � �il �L[� � V`. yF� I �} �",�.\ ,;�., .., , , . �`a 'F ..• � + ' 1 't�' '� . i y)� r �'t � s i�_ .� {l� �1 . V , '�r � �. . _� � ` �"�� Y �• , ,� ' �'l. 1 ,\ ��� 1�,{ �''��s''.t`�(y ..�.'' t nF¢ r�o`r � p��� ' ,Y,, e`� '�' � .�t�� ry��\. `�r �i,� y�� ', r� p �t{'6 . f��'4"w,. .��... "+�d� t,rr ��, t,ti c� . ' �• u,' .r, � -. 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CONTRACTOR � DESCRIPTION � �v-�+e-- �� I� tu ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINA� Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J ❑ FINAL �WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC IN ALL 2 OWNERICONTRACTOR TO MEET YOU:_YES�NO y COMMENTS: � � L � *� � ` �� . � W a � � O ). a O � W � Q � 2 W � W � J y ��WORKSATISFACTORY:PROCEED iCD PROJECT COMPLETE w ❑CORRECT WORK 8 PROCEED � �ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �pHOTO TAKEN iNSPECTOR WFLL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (J52� 249-4600 OwnerlContractor on ite: Inspector. White Copyllnspector's Ffle Canary CopylSite Notice