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Home My WebLink About2010-00426 - sewer connect • � CITY OF ORONO PERMIT NO.: 2oiaooa26 � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 06/07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3045 SIXTH AVE N PIN : 28-118-23-32-0008 LEGAL DESC : LJNPLATTED 28 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: HOMEOWNER PAID SAC CK. 11499 6/7/10 KOTHRADE S&W PAID PERMIT FEE CK 15762 6/7/10 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 KOTHRADE SEWER&WATER STATE SURCHARGE SEWER&WATER 0.50 12059 WHITETAIL AVENUE HANOVER,MN 55341 S.A.C. 2,100.00 O TOTAL 2,150.50 Minnesota State License#:0192 OWNER RYDER,JOHN&BARBARA 3045 SIXTH AVE N LONG LAKE,MN 55356- 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 da at any time after work has commenced. The applicant is responsible fo uring all required inspections are requested in co forman i State Building Code.This permit may be revoked at an me fo e se. / /�U/U / / Applicant P rmitee Sign ure Date Issued By gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABO E. . � ; FOR C( Y C�SE ONLY (� City of Orono Date Received:�� Permit# �/�—'Q�� `� P.O.[3ox 66 � ��' 2750 Kellc Parkwa � y y ❑�n-House SAC Determina[ion Form Completed � �f�� ' Crystal f3ay.MN 55323 � � o`, (952)249-4600 Approved By(If Required) ��?Gr��oe�o' - 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 aonlication is received) GENERAL INFORMATION � l. 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. Pennit 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. TYPE OF PERMIT (Check All That A I }; � Residential(May Require Approval) � Commercia) (Approval Required) ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Uisconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: �� CG� l �� -` C'� Owner: �1�� Mailing Address: _ City: �(�1� U Zip: Home Phone: Alternate Phone: Contractor lnformation: I o��.rc�� S��-i-�� a,�,.l�� Contractor: Contact Person: f ' I � , ' n p Address: (o�� W�� `' State License #: 1� ► �� l� � �-aa �r City: �� Zip:�3 Expiration Date: Phone: ��0 3` �� Alternate Phone: �� . ,l, DETERMINING PERMIT FEES � � � �SAC Charge(2010 Rate=$2,100.00) $ � � �/�� (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City 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 ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size _inches;material _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 Water Connection Permit is Issued: l. Issue Water Meter& Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: L Collect Permit Fee&Issue Water Connection Permit l. SUBTOTAL of Permit Requested: $ .�d � � � 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 _ 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� ADDITIONAL INFORMATION-Vt�ATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate�ermit. ■ 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 str'c accordance with the ordinances of the City and the regulations of the State ofi Minnesota, an�c rtifie that all state ents made on this application are,true and correct. Applicant: Date: �� I " Rese Form D E TIME ✓ CITY OF ORONO CALLED IN - � INSPECTION NOTICE SCHEDULED - ' % PERMIT NO. 4�0�� ^ ��OMPLETED � � h ADDRESS Ju�iS Ls e'�L j�(� � OWNER TELEPHONE�NO. 7`O 3 '��/�.�—TUZ CONTRACTOR � S'�(,' . a DESCRIPTION LG2�['�� C�/��CJYv � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � � �.-----� j i 0 a o � � W ' � Q � � { 2 W � W � I� �J \ , �—�' _ __ _ - �WORK SATISFACTORY:�9CEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN �NSPECTOR WILL RETURN 0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerfContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice