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HomeMy WebLinkAbout2013 - 01103 - sewer connect II 11 iii iii ! III II I II II II CITY OF ORONO * 20 1 3 - 0 1 1 0 3 2750 KELLEY PARKWAY DATE ISSUED: 10/21/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 870 WINDJAMMER LA PIN : 07-117-23-11-0012 LEGAL DESC : PIRATES COVE : LOT 008 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER CONNECTION-4"PIPE-SCHD 40 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 6501 CO. RD 15 MOUND, MN 55364 MAIL IN FEE 2.00 (952)472-4959 TOTAL 57.00 Minnesota State License#: 1804 PAID WITH CC# 7464 OWNER Infinity Custom Builders LLC 3010 BROOKS LANE WAYZATA,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 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 any time for du cause. WAX-6 /© l 21 1 Z3 iia/ 1 / 2) Applicant Permitee Si ature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Oct �,1 13 Q8:58a Westonka Mechanical 952-472-4961 p.2 16/21/2013 CB:49 9t2241d4bib ursurlu rjQ� C USE ONLY /)/11.2_3 City of Orono OarcReceive&Li ereaita o.p/3 -- 5 P.Q Box 66 [r i 2750 Kelley ciu Parkway Q In-Mouse SAC Dminatiun Form Completer! \1, Crystal Boy.MN 55323 'f (952)249-4600!Fax(952)249-46t6 Approved By(If Required)_ �rr5 Lcc•at i CITY OF ORONO-SEWER&WATER J GENERAL PERMIT (•Nnte:Sonic permits may require npproval by the Building Official andlor Public Works Department•) (A Lt_PF45)(tTS. May beadiest to further revlcw_nnd may not_beltsued when_thw_alleation Is ressivsrp GENERAL INFORMATION I. 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. Ali work must be inspected before it is covered. Call(952)249-4600,244-hour notice required. TYPE OF PERMIT (Check All That Apply) • 4,1 Residential(May Require Approval) ❑Commercial(Approval Required) New CennectionAdditional Connection K Re-Connection ❑Repairs C]Disconnect PI Water Availability Connection For Future Hook-Up to Water Job Site)Owner Information: Site Address: F-20® .4.701 dJ er,e/ I cL Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: j /�• Contractor: % l 5/ice Contact Person: I�9`1o C_.-tll( Address: bs 0 I CV, a /C State License #: City: Ch.44J 7ipq Expiration Date: Phone: 99 7.2 / c1 Alternate Phone: ((2--?of-Q 7'2 9 Oct 2..1 .13 08:58a Westonka Mechanical 952-472-4961 p.3 10/21/2913 08:49 9522494616 Ut{UNU r`""`' "` Ca Z. 'DETEi`MINI IO PERMIT FEES - • . Q SAC Charge(2013 Rate—$2,435.00) S (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(55(1,t10/Per Stub) 5 Pipe size?,,inches;material '%,L.Schd 40 air tested; cast iron Q Water Connection/Disconnect/Repair(550.00/Per Stub) S Pipe size inches;material Schd 40 air tested; copper Q Water Availability Fnr Future Hook-Up to Water($50.00) S 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 Pcrmit 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: $ �'�• 12) 2. STATE SURCHARGE $ 5,00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT EEE(Add Lines 1-3 Above) $ c'. CZ) ADDITIONAL INFORMATION—WATER METERS . • WATER METERS must be picked up and paid for at Orono City Halt,these arc on a sey_9rate 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: 10 —22—),i DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED /D,2,Z.—I3 /9.`J PERMIT NO. a 013 -01101 COMPLETED ADDRESS 2)0 - OWNER TELEPHONE NO. CONTRACTOR `V 1?c4,' C 4 3. DESCRIPTION Seam/ ot.i rk9J-,d"L- • ❑ FOOTING 0 PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORENVEfLANDS y 0 FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS • 0 FINAL SEWER HOOK-UP 0 COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP 0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:y YES_NO Col COMMENTS: cc W 'L J prati5f. b cc U �L WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE 4.1 '0 CORRECT WORK&PROCEED CIISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT 0 CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN 0 STOP ORDER POSTED.CALL INSPECTOR ❑ ITATION ISSUED 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: het as r, %i,`k. Inspector. ct4 Oat:t,� White Copyllnspector'syFile Canary Copy/Site Notice