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Home My WebLink About2012-00418 - sewer repair 111111111111111111111 ffliffm CITY OF ORONO * 2 0 1 2 — 0 0 4 1 8 2750 KELLEY PARKWAY DATE ISSUED: 05/17/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS 1005 WILLOW DR S PIN 10-117-23-24-0012 LEGAL DESC UNPLATTED 10 117 23 LOT 000 BLOCK 000 PERMIT TYPE SEWER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE REPAIR APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 ROTO ROOTER SERVICES CO. STATE SURCHARGE SEWER&WATER 5.00 14530 27TH AVE.N. TOTAL 55.00 MINNEAPOLIS,MN 55447- (763)519-3907 PAID WITH CC# 6159 Minnesota State License#:058341 OWNER SPENCER,MARTHA 1005 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 cont rmance with the State Building Code.This permit may be revoked at any ' e for due c se. /(/✓ pplicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. FOR CfTY USE ONLY O¢OG City of Orono Date Received: Permit# P.O.Box 66 2750 Kelley Parkway 0 In-House SAC Determination Form Completed d. Crystal Bay,MN 55323 (952)2494600 Approved By Of 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 subiect to further review and may not be issued when the anolication 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)2494600,24+hour notice required. TYPE OF PERMIT Check All That Apply) 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: /GbS� l�111141 �Y Owner: 1'Y CCY_ Mailing Address: D D Sr City: yDYID Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �! Pir Contact Person: off Address: A�517D Z � i�'lv� State License City: Zip: Ss`1`%7 Expiration Date: Phone: ,7/per 7 ��Z� Alternate Phone: �� e z9/ ❑ SAC Charge(2012 Rate=$2,365.00) $ (SAC,Charge must accompany all sewer permit applications unless prepaid) (O no City Staff can determine if applicable) f not prepaid,a sewer connect! er 't will not be issued) Sewer Connection/Disconnect Repair 50.00/Per Stub) $ Pipe size inches;materi 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:WO�TION-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: / DATE TIME r / CITY OF ORONO CALLED IN INSPE,TION NOTICE SCHEDULED PERMIT NO. COMPLETED it ADDRESS / VC15 Lui I (011e TJX 5 A7b3 ae 83z-3 OWNER TELEPHONE NO.��3-S/9 CONTRACTOR ( >`; DESCRIPTION �� ,` ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q El POURED WALL ❑ MECHANICAL RI El LAKESHORE/WETLANDS ti ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS El 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_ANO} COMMENTS: rc W C c o e ✓'aD S /-v �'�' � 74J Me77- LLJ CC W cc Z) /O1`iIORKSATISFACTORY:PROCEED 11PROJECTCOMPLETE rr-W/❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 11 CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. 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