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2017-01515 - sewer/water connect
! ( a CITY OF ORONO * z 0 1 7 — ra 1 5 1 5 * 2750 KELLEY PARKWAY DATE ISSUED: 1U16/2017 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 739 STONEBAY DR PIN : 33-118-23-I1-0071 LEGAL DESC : STONEBAY THIRD ADDITION : LOT 004 BLOCK 001 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW WATER AND SEWER CONNECTION APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 WATERCONNECT/DISCONNECT/REPAIR 50.00 BOLLIG& SONS,INC. STATE SURCHARGE SEWER&WATER 1.00 11401 COLJNTY ROAD 3 HOPKINS,MN 55343- TOTAL 101.00 (952)938-4133 Payment(s) CREDIT CARD 9081 101.00 OWNER Wooddale Builders Inc 6117 BLUE CIRCLE DRIVE MINNETONKA,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 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 separate 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 quired inspections are requested in conformance with the State ilding Code.This permit may be revoked at any time r due cause. � d � I , , l q�pplicant Permit ignature Date Issued By S' ature Date � � z �OR CTCY ll�i's OI�fiI,Y r5 �'���0� City of Orono Date Recei�ed: P�ii# �D I7—v SI,j ; P.O.Box 66 ; 2750 Kelley Parkway �In-I�onse SAC Determination Form Completed s ,�-f Crystal Bay,MN 55323 ``�,� • ¢�,�� (952)249-4600/Fax(952)249-4616 Apploved B (I1' acsHo Y �9uired): D/ Dfl CITY OF ORONO—SEWER&WATER/GENERAL pERMIT (*Note:Somc peamits may require approval by the Building Offieial and/or Public Works Departmq�t') (ALL PERMITS- MiV I)t���hinwf�n f��rfh*�rrvSrw,nd mev nnf�+M��a_,�._-.+.��__.�_-oon is r V 1 GEI�ERAi,INFORMATIOI� 1. You may apply for urility permits by maii or in person at the City offices. 2. Mailed in applications are subje�t to the postage and handling fee shown below. Permit cards will be sent by return mail within 2 business d.ays. 3. Permits are not valid until yon receive a permit card. 4. Work must not begin unless the permit card is available on the job site. S. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600j for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MA.iN without express approval of the Pubtic 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. TY#'E OF PER�T Check All Th�t A ❑Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ VJater Availability Connecrion For Future Hook-Up to Water Jo� Site L Ovvner In#'o�ation: Site Address: � �°7 5�_,�,�_ �,r � Owner: Mailing Address: City: �� c-.�,n.r� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ���`'y�-��50.,,y Contact Person: � ��,i�- Address: ��`�b, Ca Q.�� 3 State License#: P� � y�iy �3 City: �-�� Zip:��I�i Expiration Date: )Z � Phone: �15z Cl j�' `'(/3� Alternate Phone: �I Z y �4 z`c S� 1 / ► D�TF��.I�+C�P��tA�.i�`FE� ❑ SAC Charge(2a15 Rate=$2,485.00) $ (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 Coanection/Disconnect/Repair($50.00/Per Stuti) $ 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 Ezulanstion: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Req,nired Before Water Connection Permit is Issued: l. Issue VJater Meter&Horn Permit 2. Any Addirional Connection Fees Paid(If Applicable) Issue Water Connecrion Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: � 2. STAT'E SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ADDITIONAL INFORMATION-WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a se�arate permit. ■ 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 Oron or issuance of a Utility Permit, agrees to do all work in strict accordance with the ordinance of the City and the regulations of the State of Minnesota, and certifies that statements ma� on this application are,true and correct. /,,r� i / � Applicant: � Date: ` � ' � b " �� ✓ DATE TIME �CIT�t F ORONO CALLED IN INSpECT10N NOTICE SCHEDULED � 3_ a n�.. PERIIMTNO.;?�n� � ��5�� COMPLETED ADDRESS �9 ��/1G��'i y 1�� OWNER TELEPHONE NO.��Z"�-3�/�29�f CONTRACTOR BO��9 �S�S f�J� � DESCRIPTION � f'� L�/��G'�'� C�,'I � O FOOTiNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG y ❑ POURED WALL ❑ MECHANICAL RI D LAKESHORFJWETLANDS O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPUUNT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL p FOUNDAl10N/REMOVAL 2 OWNERICOMRACTOR TO�EET YiOU:_YES_NO s WCOMMEN'TS; SG/f �D�/' �eW 2/' �-�/��QtG � S� P� � � o �j�.,6 A �i` �c Sf' `��' 15 /�i i�rr c.� 1�S' - <�//(� � � Wf ��►�o�.� _ w�r S(�' �i c� w( � �-rp.C'��-- o� w ,�. Q � � W � J n- � V$WORKSATISFACTORIF.PROCEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWRHIN HOURS. �HOTOTAKEN INSPECTOR WILL flEfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContraator on site: �C' ,D Inspector: �� ; Whits Copyllnspecto�'s File Canary CopylSite Notice � �� :.w ` �� � . ..... ,�.. � ,�p �s . . � � . ��. . �� , , p I . . . . ' Y � , �� 4 ,w ; #�,^� ,� � � �.,g? � 4 '�4-�} 5,�� � , � rn �' � ���V�t�� '?{. - ��� � � ��ia.. �1'lit �. �� � p �. � �' '}, G .� , 4. ` ai��, f � V nYn � y � �, ,3,��.,,��,3�y pi}� � x �CI� � . ' '.�fl � ��j4� p�X�g����: �'R,.'�,'w5 Q�f'�4a��� � � . ... 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