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Home My WebLink About2017-00118 - sewer connect CITY OF ORONO * 2 PJ 1 7 - 0 PJ l l s 2750 KELLEY PARKWAY DATE ISSUED: 02/09/2017 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 230 TONKA AVE PIN 05-117-23-14-0029 LEGAL DESC BAYSIDE ADDN TO LAKE MINNETONK LOT 000 BLOCK 002 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE CONNECTION NOTE: SEWER RECONNECTION-SAC PAID 5108-05/08/16 CONTRACTOR:PAID FOR A SEWER&WATER DISCONNECT ON PERMIT#2017-00057 01/20/17,WHERE WE COLLECTED$101.00. HE REALIZED AFTER GETTING OUT TO THE JOB THAT THERE WAS NO WATER AT THIS ADDRESS. SINCE HE ALREADY PAID THE COST ON THAT PERMIT,WE ARE NOT CHARGING THE SEWER CONNECTION FEE ON THIS PERMIT. SINCE IT WAS ALREADY COLLECTED,RATHER THAN ISSUE A REFUND ON THAT PERMIT AND RECHARGE THE SAME FEE. WE WILL COLLECT THE SURCHARGE FEE ONLY. OK'D BY ROGER. APPLICANT STATE SURCHARGE SEWER&WATER 1.00 GROTH SEWER&WATER TOTAL 11.00 Payment(s) 775 TOWER DRIVE CASH 1.00 HAMEL,MN 55340- (612)919-0247 OWNER Everlast Enterprises Inc 4109 NORTH SHORE DR MOUND,MN 55364- 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 governing 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 are requested in conformance with the State Building Code.This permit may be ��/ l revoked at any time for due cause. I)A4 Z� /W/2 Applicant Permitee Signati.Ye Date Issued By Signa re Date r / POR CrrV USE ONLY / OO\ City of Orono DateReceived: Permit ti 2Cl � 1 P.O.Box 66 2750 Kelley Parkway ❑In-House SAC Determination Form Completed Crystal Bay,MN 55323 ? cX/9 CITY(952)249-4600/Fax(952)249-4616 Approved By(If Req CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMM- May be subiect to furtber review and may not be issued when the application is received) GENERAL INFORMATION 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 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 Apply), Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑Additional Connection [a Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Joh Site/Owner Information: Site Address: 0")L<q Ave Owner: G_JRAC,S+ Er nSeS Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: 61rofk S c w e 4-1-c-�� Contact Person: —0,,k Al it(ku Address: T� r l�� State License#: City: r 1�'""e Zip:55s'40 Expiration Date: Phone: dl 5 - 6 3 y Alternate Phone: DET.FRIbINM PERAfIT FEES t ❑ SAC Charge(2015 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not pre ' a sewer connection permit will not be issued)Sewe onnect' n/Disconnect/Repair($50.00/Per Stub) $ T711 P' a size inches;material Schd 40 air tested; cast' n �� 1 ❑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 Availability 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: 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: $ 2. STATE SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 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 permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of meter 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. Applicant: S"'� 'y Date: � ( � l i l