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HomeMy WebLinkAbout2016-00329 - water connect CITY OF ORONO * 2 0 1 6 - PJ 0 3 2 9 * ,� 2750 KELLEY PARKWAY DATE ISSUED: 04/OS/2016 j ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3596 SHOREL[NE DR PIN : 17-117-23-43-0107 LEGAL DESC : NAVARRE HEIGHTS : LOT 000 BLOCK 007 PERMIT TYPE : WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: ADDITIONAL CONNECTION FOR FIRE SUPPRESSION,OK'D BY ROGER APPLICANT WATERCONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 INDUSTRIAL UTILITIES INC TOTAL 51.00 P.O. BOX 76 HLJGO,MN 55038 Payment(s) CREDIT CARD 8481 51.00 (651)426-6120 Minnesota State License#: SW-PC643306 OWNER A Plus Properties 3596 SHORELINE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry 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 separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified hereia 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 are requested in conformance with the State Building Code.This permit may be _ /� revoked at any ti for due cause. .�, _ I�,v � I���t�c.� � G��� _� - � �� �� 1 App icant Permitee Signature Date Issued By Signature Date � �.,rrs 9. �y-�/-!� �o crr����se a;r�.�� �j' ���1.�-�t�F`� City of Orono Da�e xeceiced� ,�-1.�'�_lQPemut N Z�l�'� � � � f>o.��.6� �v ! �� �� '7�U RcII���P�rk�va� � 0 In-Nousc SAC G�tennination Porm Completed /� _ �t � Cnstal F3it� Mlv 55323 ' j � � �� f�)52)2=19 dbtx3!Fax(95'_}2�39-d51� ��� � pproved B�(If Itequireci): , � \ �.� �� 4 / CITY OF ORONO–SEWER & WATER/GENERAL PERMIT (*\ote:Some pennns muc require approe�al h�the Building O�iicial andlor Public��orks Derarun4nt*) (V t PFR�11l�S �lat�tx subiect tu further re��ie��and mac not be ieeued whrn Ihe annlieation is receit�eli) GENERAL INFORMATIUN � 1. You ma�apply t<�r utiliry permits b�•mail or in person at tt�e C'ity o�ffices. 2. �lailed in applications are s�ibjeet to the postage and handling fee shotvn b�low. Permit cards�rill be sent by return mail wiChin 2 business da}s. 3. Permits are not valid until you receive a permiC card. �. ��'ork inust not begin unless tiie permit eard is available on thc job site. 5, l,'tiliTy�conneetion permits may be issued to licensed contractors onl��. 6. Contact the Public�'�'orks I)epartment(952-?49-4G001 for utility slub as-built locations. DO NO"� EXCA�`A"I'E [N A1l'ST'REET AND DO 10T TAP ANY �1A1?�wiihout express appro��al of the Nublic��'orks Department. lssuance of a permit does not grant this approval. 7. All���ork must be donc in accordance��ith State Code requirements. 8. All work must be inspeeted before it is cc�vered. Call(952)2�9-�600.2�+hour�iotice required. TY['�OF PERMI"t' Check All That t� I � ❑ Residential�I�1ay Rec3uire�pprovall �Commercial(�lpproval Required) �v re�;r��S u�Q�SSi�'► �New Conneetion ,�Additional Connection ❑ Re-Coiuieetion ❑ Repairs ❑ Disconnect ❑ \btater Availability°Connectioi� 1=or Future H�ok-Up to�'V�ter Job Site/Owner Information: Site Address: 3 S`�� J�o�E���E U�. Owner: �P�^'- "��.�r c.� ,c Mailing Address: 3 S9� SK,,,Rt,.�,�� o� . c���: oRoNU z��: ,�s34/ Hame Phone: .Alternate Phone: C;ontractor [nformation: Contractor: +`��us T���� "���:T��s��� Contact Person: �u sT� V���+�s � PC 6�k33o� Address: �• °� �O" �' State Licei�se tt: �-��-�— 1�. 3t t� City: ��`'`�° Lip:��� Eapiration I7ate: i2�3� � Phone: �`�t `��-� �1� Alternate Phone: �t 2 �- 55�f - 3 S2� __� DETERIV�1?�tING PLItM[T FEES ❑ SAC Cl�arge(2016 Rate=�2,.385.00) � tSAC Charbe iriust accompany all sewer permit�applications unless prepaid) (Orono City Staffi can determine iPapplicabie) (If not pre�>aid,a seH�er connection permit will not be issued) ❑Se�vcr Connection/Disconnect/Repair(��OAO/1'er Stub) � Pipe siz_e inches;materiai Schd 40 air tested; c�st iron S o0 �1'ater Cc���necti�rn/I)isconnect/Repair(550.00/Per Stub) $_ � ___"`-_ Pipe sve_(.�,. _ inches:n�aterial D��° Schd 40 air tested: copper ❑ Water availa�bility For Future Hook-lip Yo li'ater($�0.00) $__ i �'1�:�ter.Availabilitv Explanation: � Contractor installed line to inside of house for future hook-up. This line will be inspected b��the Public VJorks Departmcnt. Required Before Water Connection Pcrmit is Issued: I. lssue!k'ater h�ieCcr& Horn Permit ?. ,4ny ,�dditional Connection Fees F'aid(IfApplicable) Issuc\'�'ater('�nnection PermiC: 1. Collect Permit Fee&tssue�'�%ater ConnecCion Permit � . vo O '"' 1. S[16"1'OTA1.,of Pennit Requested: � Z. STA'I'E SURCHARGE $ ___I.00 3. POST,'�GE&HANDL�[NG Ivnly c�n iviail-In ,�pplications) $— ---„��`^' --- b� �4. TOT,aL {'Ef211�11T FEE(Add L,ines 1-3 Abovel � S � ✓ � ADDITIONAI� iNF�ORMATION —WA"TER METERS ■ WATER;1IETERS must be picked up and paid for at Orono Cit� Hall,these arc on a scparate permit. ■ WATER �ti1ETERS must be set and se�led b� O�•ono 1Vater Depxrtrnenf (952) 249-a600, upon completion of ineter installation. The undersigned hereb� applies to t}�e City of�rono for issuance ot� Utility Permit, agrees to do all ���oek in striet accorclance with the orclinances of the City and the regulations of the State of Minnesota.and ce��titics that all statements made on this application are,tr�ie and correct. �``' `�-`�� Zo l npplicant: .�-e--,�--�-�U-''-'e.,Q''a"Y- _ _ _..._ Date: _ _--� � CITYO�ORONO CALLED IN �D� /� TI � INSPECTION NOTICE EDULED — C��" UT� PERMIT NO. OZD /l0'�� MPLEfED ADDRESS g �NNER � P �N . �Z J�S -�'1' SZ6 CONTRACTOR �� � � </ �Q" 1l`��r�S � DESCRIPTION ' � 41 ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL Q ❑ 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 � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNENCONTRACTOR TO MEET Y�OU:_YES_NO o � COMMENTS: � �/' I � � / /'� 4 ��J v S D � 0 � ° ��tJ� .�¢ �� ��iuQ � _ Q � � W � � Q7�C.1NORKSATISFACTORI!PROCEED ❑PROJECTCOMPLEfE w ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑(�FiRECT UNSAFE CONDITION WITHIN HOURS. pF{pT0 TAKEN INSPECTOR WILL RETURN ❑ TATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Cafl for the next inspection 24 hours in advanoe. (952) 249-4600 Owr�eHCoMreCtOr on site: U r�(n• Inspeator: � ` WMte CopyAnapecto�'s Flls Cenary Copy/SiM Notice DATE E CITY bF ORONO CALLED IN INSPECTION N TIC SCHEDULED -�3/Io O�� PERMIT NO. ��COMPLETED ^ ADDRESS ����7 9� /I� p �f OWNER TELEP NE NO��a������ CONTRACTOR ��SI�7�'J �/ /Q S � DESCRIPTION �/� /,/��i4��A�-e W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT e ❑ FINAL WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY �SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL � 2 OWNERICOI�fiRACTOR TO MEET YiOU:_YES_NO �I � COMMENTS: �rr'� ►•�e ' 6 � —��t-^�C f'i a i� ��� /D � �i j'ur� �.v2� o �., e� �1?. �1 a��n 4 � ,�I s�'' ����— a �e�-n�� �v�".p 5 0 W 0� Q � � W � � W,�1NfORKSATISFACTORY:PFiOCEED �pJECT COMPLETE � �� ❑CORRECT W'ORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CANDITION WfTHIN HOURS. ��TO TAKEN INSPECTOR WILL RETIJRN ❑GTATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cafl br N�e next inspection 24 hours in advarx:e. (g52) 249-4600 OwnenContractor on site: ��n aI�5�i-i�J �' Inspector: �7�r White CopyAnspectoPs Fil� Cenary CopylSMs Notkx :, V DATE TIME CITY OF ORONO cnILED IN INSPECTION NOTICE SCHEDULED �� � PERMR NO.o70,(fQ-1a03a9 COMPLET ADDRESS ���� Uh ` ���(� OVUNER � T L P�10/�I�NO.����5 -352 CONTRACTOR (,C S f Zl! �S ��SfZYI G(�l�/��IS �� r � DESCRIPTION � LU W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ 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 � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET Y�OU:_YES_NO � COMMENTS: � _�� � ��a��S � 0 � �' rd y�,� T�i Pl�c � m�;•. �d � o ' Fi'o m �O , , ��n r 1 a�i^�J � �G I�..�(�'�o �A �a�< �'A��i fi �.�,` � nr 1 Q � W � W � j O � ❑WORK SATISFACTORY:PROCEED ❑ PRW ECT COMPLEfE W ❑CORRECT 1MORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 O CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �HOTO TAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. 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