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Home My WebLink About2005-P08795 - sewer connect . �- PERMIT CI�"Y OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p08795 Crystal Bay, Minnesota 55323 Permit Type: Sewer and Water Permit (952) 249-4600 Date Issued: 6/1/2005 SITE ADDRESS: 1280 Spruce Pl Unit# Mound,MN 55364 P�� 08-117-23-32-9999 DESCRIPTION: Proposed Use: Residenrial Permit Class: General Permit Type: Sewer and Water Pernut Pernut Sub-type(s): Sewer Connecrion DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: SAC Grandfathered in#2651 3/25/71 FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: J.S. Stewart Companies OWNER: Gregory&Jeanne Gustafson 5606 94th Avenue N. 370 Golfview Rd#801 Greenfield,MN 55357 N.Palm Beach,FL 33408 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CO MENTS. � � � PLICANT PERMITEE SIGNATURE UED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � � _� � ' FOR CITY USE ONLY 4�� Clty of OrOno Date Received: Permit# P.O.Box 66 ��;;.,�„ � 2750 Kelley Parkway ❑In-House SAC Determination Fonn Completed � y��,�'' �* Crystal Bay,MN 55323 �^�',i,��.�o (952)249-4600 Approved By(If Required): '�asxoa CITY OF ORONO— SEWER & WATER/ GENERAL PERMIT (*Note:Some pennits 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 aaolication is received) GENERAL 1NFORMATION 1. You may apply for utility peimits by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Peimit cards will be sent by retuin mail within 2 business days. 3. Permits are not valid until you receive a permit card. 4. Work must not begin unless the pemut 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 urility 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 OF PERMIT (Check All That Apply) �-Residential(May Require Approval) ❑ Commercial(Approval Required) [�.New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑ Disconnect Job Site/ Owner Information: Site Address: / � � Owner:��u��cl �crn�{, Mailing Address: `{`{�? ��-�-f� �� I��P. City: ��c�"�P� t't4-12� Zip: �� / Home Phone: _��—`��/" C�� Alternate Phone: Contractor Information: Contractor: ��, ��l��L'v Contact Person: Address: �� ""'tO7�' � State License #: Lo� G� City: �i4�o t�€� Zip� Expiration Date: /LI�<� �a(�, Phone: �2��• AlternatePhone: ��3-��?�c63 � � � � �� : 1 n � ;�3 �k �k � � � � ` r �' � � � a'� i ..., . . � , �� ,;:� . „ . . . . , . . , . . . . :�: � �" � i .� .?: r � - � DETERMINING PERMIT FEES ❑SAC Charge(2005 Rate=$1,450.00) $ (SAC Charge must accompany all sewer pernut applications unless prepaid) (Orono City Staff can deternune if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ 35 � Pipe size�inches;material�Schd 40 air tested; cast uon ❑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) $ ADDITIONAL INFORMATION-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 rtifies t statements made on this application are,true and correct. � App icant: Date: � � � � i ' ,x .f ; �; ,, ; ,, ' 4 p _ :I ; � a � � t' � .�: � � � , , � � � A C a� �' .� � �; � ,� � � � ( � � � �� , ,. . � �., � �t�� f �� :. � . �� . SEWER& WATER PERMIT IN HOUSE FORM-TO HELP DETERMINE SAC UNITS FOR CITY USE ONLY (*Please Key This Information On Comment Line Of Permit*) Date Completed: 6'� D-� #Of SAC Units Completed By: ❑ *SAC Prev[ously Paid- Permit# Date of Permit *Charge 1 SAC Unit Per Home ' *1f Multiple Homes Or Units-May Need To Pay Additional SAC Charges � ��,L�,., a6s� _1� *SAC Grandfathered In— `��J Permit# 3 �1 Date of Permit *Must have had Hook Up&Home Prior To January l, 1973 *'Refer to'Helpful Hirtt Sheets,OrAsk IfNecessary' ' *If Multiple Units-May Need To Pay Additional SAC Charges ❑,*Commercia!— ' Permit#Accounted For Date of Permit ❑ *Letter From Met Council—Showing Use-Or Additional Units Needed-' *Contact'Jodi at(651)G02-1113 To Obtain Letter(Usually Building Official Obtains) *Copies To:Lyle,Street File&One On Copy'Of Pernut For Reporting *If unable to determine;will have to wait to be'issued until determinarion can be made ❑ SEPTIC Area- ***WATCH FOR THESE CONNECTIONS*** *Person Will Have To Pay Connection Fees&Assessments+SAC Charges *Refer To Current Year Fee Schedule! Don'tRelease Until Fees Are PAIDf , (Ask for Greg or Mike's Help With These) *Will Need Approval From Public Works(Greg'Gappa) ' ❑ Special Grinder Pump Needed *Have Them Talk To Greg Gappa For Questions&Pricing *Give Them Special Hand Outs!(In Drawer With Sewer Permit) ❑ Pemut Needs Approvai From Public Works: Approved By: C� � �J(}�� i� DATE TIME CITY OF ORONO / AL�f�6 iN � 3 f �d�_ INSPECTION NOTI � scHE�u�E� U �,�..�.�j PERMIT NO. c PLETED ADDRESS ��-� C� . �r L� �--p��c� OWNER CONTR. �S �1`�i.LCL/t TELEPHONE NO. � �� '� ��CG '"�J�X J � DESCRIPTION <�� L Jhl"! � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU�YES_NO � COMMENTS: � W a � r � e,r � 0 � � 0 � W � Q � z W � W � j a , W� �/VORK SATISFACTORY:PROCEED f� PROJECT COMPLETE WPO CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next in ection 24 hours in advance. (952� 249-46�� Owner/Contrac�i - Inspector. -�-�`� White Copyllnspector's File Canary CopylSite Notice