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HomeMy WebLinkAbout2014-01439 - sewer disconnect only • CITY OF ORONO * 2 0 1 4 - 0 1 4 3 9 • 2750 KELLEY PARKWAY DATE ISSUED: 01/08/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS 825 WILLOW DR S PIN 10-117-23-22-0001 LEGAL DESC UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE DISCONNECTION NOTE: SEWER DISCONNECT ONLY APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 5.00 GROTH SEWER&WATER TOTAL 55.00 775 TOWER DRIVE Payment(s) HAMEL,MN 55340- CHECK 6912 55.00 (763)478-6712 OWNER BRUNELLO,JOHN 825 WILLOW DR S 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 at any time for due cause. p �-V7�C"V7 U Applicant Permitee Signature Date Issued B ignature Date 4 City FQ ITY S nut#O�L Cl Of Orono Date Received. ennit# P.O.Box 66 2750 Kelley Parkway ❑In-House SAC Det rmination Form Completed Crystal Bay,MN 55323 r (952)2494600/Fax(952)2494616 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) f Residential(May Require Approval) ❑Commercial(Approval Required) ❑New Connection ❑Additional Connection ❑Re-Connection ❑Repairs %Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: 1 f ©�-✓ Owner`SAAi FDRJ e 1�a Mailing Address: City: +' (' Zip: Home Phone:���Z'ZZ t ``1 O Alternate Phone: Contractor Information: J� C Contractor: • q) ►l'—seContact Person: Address: 7 7_�'7oLvv- V r 1✓_oState License#: �I �f 6 City: Zip--"- Y Expiration Date: Phone: C /Z __&7-5U37_ Alternate Phone: DETERMINING PERMIT FEES ❑SAC Charge(2014 Rate=$2,485.00) $ (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 Connectio Disconnect/ pair($50.00/Per Stub) $ Pipe size inches;material 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. 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. 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: �( � MINNEHAHA CREEK WATERST��L�IF STRICT QUALITY OF WATER QUALITYE Inspection/Analysis/Monitoring Fees The Minnehaha Creek A site inspection and monitoring by District staff will be performed where the Watershed District is activity involves: committed to a leadership • a commercial/industrial/multi-family residential development • a single family residential development greater than 5 acres or of any size if role in protecting, within the Minnehaha Creek subwatershed improving and managing • any alteration of a floodplain or wetland • dredging within the beds, banks or shores of any protected water or wetland the surface waters and • a violation • any project which in the judgment of the District staff should be inspected due affiliated groundwater to project location, scope, or construction techniques resources within the District,including their In these cases, the applicant shall pay to the District a fee equal to the actual relationships to the costs of field inspection of the work, including investigation of the area affected by the work, analysis of the work, and any subsequent monitoring of the work, ecosystems of which which in the case of a violation shall be at least $35. they are an integral part. We achieve our mission Standard Fee Schedule through regulation, District professional staff $ 65.51 capital projects, District interns $ 40.35* education,cooperative District clerical staff $ 46.69* Consulting Senior Engineer $ contracted rate endeavors,and other Consulting Engineer/Technician $ contracted rate District Counsel $ contracted rate programs based on Application fee $ 10.00 sound science, Copy costs $ .25 + actual staff time Color copy costs $ 1.00 + actual staff time innovative thinking,an informed and engaged constituency,and the * Hourly cost effective use of public fi nds. 15320 Minnetonka Boulevard, Minnetonka, MN 55345 •Office: (952)471-0590 9 Fax: (952)471-0682 9 www.minnehahacreek.org MINNEHAHA CREEK WATERSHED DISTRICT QUALITY OF WATER "~* QUALITY OF LIFE Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information contained in the permit application, correspondence, plans, maps, and all other supporting data submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant r named below for use and development of land in the Minnehaha Creek Watershed District. Issued to: John Brunello No: 13-512 Location: 825 Willow Drive S Orono Purpose: Erosion control wetland protection— Single family home Date of Issuance: 07/31/2014 Date of Expiration: 07/31/2015 By Older of th( -Boprd of Managers Courtney Hall District Technician This permit is not transferable without District approval, and is valid to the date of expiration. No activity is authorized beyond the expiration date. If the permittee requires more time to complete the project, an application for renewal of the permit must be received by the District at least 30 days before expiration. ---- The applicant is responsible for compliance with all District Rules and for the action of their representatives, contractors, and employees. - = Conditions: Project to be completed as described in plans submitted to the MCWD office on January 9, 2014 according to the provisions of this permit. - - • Properly install and maintain all required erosion control measures until the disturbed areas are re-stabilized When the site is re-stabilized and the MCWD staff has performed a final inspection, all silt fences must be removed (Statement concerning fees for inspections, violations, etc... on following page) 15320 Minnetonka Boulevard, Minnetonka, MN 55345.Office: (952)471-0590•Fax: (952)471-0682•www.minnehahacreek.org 00 0@0 ERR .14 O 9 N V m 9 o C N•TD S L=j�=m _=m m m �N a vQgvov ovovvovv v�vvvoo vQv v ovvvv Qvvvvovv ovvoQgvv vQm o o as �������� �� ��� � �� �� � � �a��� ss �a ��� e y as as "aauaaa65asaao" aa"a6ac68uaM I aaaoao aaa � o-a aaa- asaaz -n 'o „�"� ^�Cc cccc C-�� y 8 Ao Z,rn+.2000000•n•. mmmmm Oo c e o n c A.m G a O As- gaar� az $gqaay9gqaagg �3�$ 9�= yx =�a � < 8g _� 4gmA _ $$ _ S aaaaa- a A o 5er Ln pr Ri C y � a � • • I / i /' 25 / �7 z O f • !� :31 �S 25 • r I Y :: (syr - "� -. I ``►& of wo 369Se-Z pp� .�" 5Z�N00*12' ' 25.5.00 - I _ 1 � • _ s s z -_�� 'a3Xg 9 m �l as "Y5 aste `>.,5 pAi,��'j�e�7 C ^g� k RT^e r >a a,ag �• n_ 2P3oCQ E_ ig Cal ao m S m p t� n 995 > - > ="ES$3a ss�s aTa s Ac F U_ ° � °' a a' aS E� ��mDGo.EE e D c0 ,osm 2 0 X S� � �Q ,°z z � a�� � � 3�'� a ?• � e��C z�s S �� a�g �E € QRS _ 3r°s_E �E _ g� QQ y P: rG oS m o 'o ''i g E' R S• ma� 5 NNs gda g3 �Z T°3'a_<' Ra C (��� v I a<_; C. a wS k$5-aap o . a �R a o F 10 E �s y O CERTIFICATE OF SURVEY m m $= i QRS SUR z pm Nva m oA PREPARED FOR W�?�/" ' 0 SATHRE—BERGQUIST, INC. Oo'o m go m m a v i m ¢ 150 SOUTH BROADWAY WAYZATA,MN.55391 (952)476-6000 O D m `m JOHN BRUNELLO z < O ~ERs PSP '9 Ben Vandeputte From: Amanda Bednar[abednar@minnehahacreek.org] Sent: Friday, December 12, 2014 11:54 AM To: ben@samslandscape.com; Christine Mattson (Orono); Melanie Curtis Subject: RE: 825 Willow Drive South, Orono. Demolition. MCWD permit Attachments: 13-512 Plan - rec. 1-9-2014.pdf; 13-512 permit.pdf; _Certification_.htm Good morning, Thanks for clarifying the application for 825 Willow Dr.S, Orono. MCWD issued the single family home erosion control and wetland protection permit for this July 31,2014.Attached is a copy of the permit and approved site plans. Ben has clarified that he will be using the location of the silt fence on these plans for the demolition of the existing home in order to ensure the wetlands are protected.We do not require a separate demolition only permit and have disregarded the items submitted to Tom below. Christine and Melanie, please let me of any questions or concerns with this. Thanks, Amanda Bednar District Representative 15320 Minnetonka Blvd. Minnetonka, MN 55345 952-641-4581 IV MINNENAHA CREEK WATERSNED DISTRICT From: Ben Vandeputte [mailto:ben@samslandscape.com] Sent: Friday, December 12,2014 8:55 AM To:Thomas Dietrich Cc: Ben@samsiandscape.com Subject:825 Willow Drive South, Orono. Demolition. MCWD permit Hi Tom Attached please find the following items: 1:Water Resource Permit Application 2: Erosion Control form 3: Site survey, showing silt fence and other information Let me know if you need any additional information Best way to contact me is via email or cell: 612-267-5253 Ben Vandeputte Sam's Lawn Landscape & Property Maintenance 1960 County Road 90 Suite 300 Independence, MN 55359 763-478-0200 763-478-0300 fax z �/ CITY OF ORONO CALLED IN DATE TIME INSPECTION NOTICESCHEDULED / PERMIT NO-21) a-6 1439 COMP ADDRESS ( 015 ® '`S OWNER TELEPHONENO. � '43(a7' 5 O CONTRALTO' Q l DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 Z OWNERICONTRACTOR TO MEET YOU: YESI(NO _ COMMENTS: 1�!Ui , ✓C J 0 cc 0 2 W cc Q 2 W W cc � 7 WORK SATISFACTORY:PROCEED ElPROJECT COMPLETE cc I W CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours iadvance. (952) 249-4600 OwnerlContractor on site: Inspector. White CopylInspector's File Canary Copy/We Notice