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HomeMy WebLinkAbout2011-01497 - new sewer connect CITY OF ORONO PERMIT NO.: 2011-01497 ` 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 12/01/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 724 TONKAWA RD PIN : 05-117-23-34-0003 LEGAL DESC : PARTENS POINT 1ST DIV : LOT 010 BLOCK 000 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE CONNECTION NOTE: NEW SEWER CONNECTION-4"PIPE-SCHEDULE 40 AIR TESTED APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 HIGHVIEW PLUMBING INC. STATE SURCHARGE SEWER&WATER 5.00 j 4301 HIGHVIEW PL TOTAL 55.00 MINNETONKA,MN 55345 (612)916-0445 PAID WITH CC# 1704 OWNER ZAWOYSKI, STEPHEN&SARA 724 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 inspections are re nested in conformance with the State Building Code.This permit may be vo ed at any time for due cause. Applicant Signature Date ISSM By Signature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. i ±�RQiT'"U$1til�' O�O�OCity of Orono AaRccd, enxnt# P.O.Box 66 G 2750 Kelley Parkway 1��n,$©a&e sAC petarioma m?iPleted �-a a� Crystal Bay,MN 55323 `? y (952)249-4600 Apprctvdc 83+ fltent�tredJ 4 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) C� SsRALi-GRUmA ON h 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. . � T Residential(May Require Approval) ❑Commercial(Approval Required) ❑ New Connection ❑Additional Connection Z Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water �J��'Site l��er�Tnfar�nat�c�xl. Site Address: o� / Owner: T Mailing Address: 7a /�11 City: V/L,L� Zip: S ) 3 J Phone: 5 —.-Hoe Alternate Phone: Cor ca r:&11 ion. Contractor: Contact Person: Address: X301 1416'h1V1G0 PLA-4 State License#: City: Zip• S3YS'Expiration Date: /2 -31-,)26 Phone: ��� �1 3- 6oc> Alternate Phone: 6-4 :L- q/6-6 Y`�Y ❑SAC Charge(2011 Rate=$2,230.00) $ (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 Lf inches;material i✓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 Availability Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Reouired 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) $ ■ 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: Date: I d� /ATE TIME V CITY OF ORONO ��I /Z � INSPECTION NOTICE SCHEDULED o PERMIT NO.eRL - / Cam LETED ADDRESS Z OWNER ELE NE NO. / - -Q CONTRACTOR lJ� DESCRIPTION �� -� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL O [:1 TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ 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 COMMENTS: cc W 0. 7-6 (_eJ c/ A S— LU 0. Q z erre -7'c W z W CC O W M'UORK SATISFACTORY.PROCEED ❑ PROJECTCOMPLETE cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. w White CopylInspector's File Canary Copy/Site Notice