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Home My WebLink About2015-00215 - sewer repair JUMUHHEMEM CITY OF ORONO * 2 0 1 5 - 0 0 2 11I5 d 2750 KELLEY PARKWAY DATE ISSUED: 02/20/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 473 TONKAWA RD PIN : 06-117-23-41-0092 LEGAL DESC : MINNETONKA SUMMIT PARK LOT 000 BLOCK 001 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE REPAIR NOTE: SEWER REAPIR ONLY,BREAK ON 4"MAIN APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 5.00 GARY'S SEWER&DRAIN TOTAL 55.00 4440 ENCHANTED DRIVE MOUND,MN 55364- Payment(s) CHECK 5282 55.00 OWNER FRITZ,DAVID&PHYLIS 473 TONKAWA RD 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 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 i ections aye' requested in conformance with the State Building .This f`imit may be revoked at any tune for due cause. ONKyq UL r ) Applicant Permitee Signature Date Issued By Signature Date f f FOR CnT USE ONLY City of Orono Date Received: Permit# P.O.Box 2750 Kelley Parkway E]In-HouseSAC Determination Form Completed i•'� Crystal Bay,MN 55323 (952)249-4600/Fax(952)249-4616 Approved By(If Required}: CITY OF ORONO-SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- May be subject to further 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 ❑Re-Connection >epairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: 3el Owner: ' tl r I" -L/ Mailing Address: / ;7- A A,,� City: 0 rV Zip: Home Phone: Alternate Phone: Contractor Information: r Contractor: �+' S Contact Person: ( 1 / - 49 Address: y��D i�GLt�vth� State License #. Z �� City: &IU at' t Zip: Expiration Date: 12 Phone: ��l" Zl�^ ��l`� Alternate Phone: ❑SAC Charge(2015 Rate=$2,485.00) $ ZCCge must accompany all sewer permit applications unless prepaid) y Staff can determine ifapplicable) paid,a sewer connectio pe it will not be issued) ❑ ection/Disconnee�/ epai ($50.00/Per Stub) $ Pipe size inches;material chd 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 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 $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 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. ll 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: ^ Date: DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED a PERMITNO.�DIS� -S COMPLETED ADDRESS 70on�w.e OWNER TELEPHONE O. I ' CONTRACTOR DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL zu v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO WCOMMENTS: rt15 Cc ° n -5 I l'Ci ll r /40fi4/7 61 j i 61 W Q W W J d WRK SATISFACTORY:PROCEED >/;ROJECT COMPLETE Cc W ❑CORRECT WORK&PROCEED C1ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN INSPECTOR WILL RETURN 13 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 Owner/Contractor on site: Inspector. � KVT White CopylInspector's File Canary Copy/Site Notice 73 A,& �,/�♦.�. .ss^^5� rµ�llr s.�' r�•I G/�� _ X31 - �r � �.r T/ rF� t , .► #Y + 1 X 5 G . 1 l 4 r �i a�