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HomeMy WebLinkAbout2017-01095 - sewer disconnect 11111111111111111F FRIMM CITY OF ORONO * 2 0 1 7 ]WP 0 1 0 9 5 -,� 2750 KELLEY PARKWAY DATE ISSUED: 10/17/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS 1080 TONKAWA RD PIN 08-117-23-13-0011 LEGAL DESC AUDITOR'S SUBD.NO.217 LOT 009 BLOCK 000 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE DISCONNECTION NOTE: SEWER DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 WICKENHAUSER EXC TOTAL 51.00 13650 CO. RD 41 COLOGNE, MN 55322- Payment(s) (612)270-7766 CREDIT CARD 0844 51.00 OWNER AHLERS,DAVID 1080 TONKAWA RD ORONO,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 requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. /a l L7 / 17 Applicant Petmitee Signature Date Issued By SYgnature Date Sep.09.2017 03:53 PM WICKENHAUSER EXCAVATING 9524662231 PAGE. 3/ 4 'V F� C USE ONLY SUN \ City of Orono Dato Recoiv Permit AoL/� 1 P.O.[sox 66 2750 Micy Parkwuy ©In-House SAC nolcrmination Ironn Complc4' ' r ' Crystal Bay,MN 55323 .r<' �• 52 249-4600/Pax 952 249 4616 Approved B If Required): r CITY OF OR.ONO— EWER&WATER/GENERAL PERMIT (+Nobe!Some pormita may mquiro pproval by the Building Official and/or Public Works Dopartmont•) GENERAL IwOR.MATION 1, You may apply for utility perm�ts 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 snail within 2 1•usiness days. 3. Permits are not valid until yoi receive a permit Card. 4. Work must not begin unless the permit card is available on the job site. 5. Utility connection permits may a issued to licensed contractors only. 6. Contact the Public Works Depa ent(952-249-4600)for utility stub as-built locations, DO NOT EXCAVATE IN A Y 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 accor ance with State Code requirements. 8. All work must be inspected bef t re it is covered. Call(952)249-4600,24+hour notice required. TYPE OF PERMIT heck All That Apply) a Residential(May Require Approvals ❑Commercial(Approval Required) ❑New Connection ❑Additional Cpnnection ❑Ro-Connection ❑Repairsfid Disconnect ❑ Water Avail bility Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: /0 YO Tdr7 AA h/4 ROg Owner: v,-d A h le,(s Mailing Address: d h lel's_8o t4 4o f.cam City: Zip: Home Phone: Alternate Phone: d Z-' 6 Z- 3 Contractor Information: x�avat%may Contractor: (4/1 G4?/h421/-rp Contact Person: O r7 Address: 136P 60, State License#: City: co/'q h fZip:553Z�Expiration Date: Phone: 612-- Z'70 Alternate Phone: i I I i Sep'09.2017 03:53 PM WICKENHAUSER EXCAVATING 9524662231 PAGE. 4/ 4i ,a I DETRMINING PERMIT.FEES ❑SAC Charge(2016 Rate c$2,485.00) $ (SAC Charge must accompany all sower permit applications unless prepaid) (Orono City Staff can determine If applicable) (it not prepaid,a sower connection permit will not be issued) Sewer Connectlithok-7Discodnect/ palr($50.00/Per Stub) $ Pipe size inc es;in terial Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;m terial Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Ave I ili Explanation, Contractor installed line to inside of house for future hook-up. This line will be inspected y the Public Works Department B&Quirod Before Water CjggggtionP r i : 1, Issue Water Mete &Horn Permit 2. Any Additional C I bnnection Fees Paid(If Applicable) i Issue)Mater ConngRlign Pernnix; 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL,of Permit R ested: � 2. STATE SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE A Id Lines 1-3 Above T ADDITIONAL FORMATION—WATER METERS WATER METERS must be picke up and paid for at Orono City Hall,those aro on a separate permit. ■ WATER METERS must be set Ind sealed by Orono Water Department(952)249-4600, upon completion of meter Installation. I 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 state nents made on this application are,true and correct. r q Applicant: 08bV �� Date: I '" DATE TIME CITY OF ORONO CALLED IN INSPECTION NOT!feE SCHEDULED PERMIT NO. I _ © COMPLETED ADDRESS 101,13,C) OWNER TELEPHONE NO. _7� CONTRACTOR DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL ❑ 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 ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO H COMMENTS: cc cc Lill 4 U. W Qc Q 2 W W cc W Ill ORK SATISFACTORY:PROCEED ElPROJECT COMPLETE WCORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COWERING 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 OwnedlContractorsite: Inspector. White Copy/Inspector's File Canary Copy/Site Notice