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Home My WebLink About2008-00435 - sewer/water disconnect ! � CITY OF ORONO PERMIT NO.: 200&00435 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/04/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 2660 CASCO POINT RD PIN : 20-117-23-24-0002 LEGAL DESC : UNPLATTED 20 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: WATER&SEWGR DISCONNEC"� APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 35.00 ADVANCE WALL SYSTEMS, INC. WATER CONNECT/DISCONNECT/REPAIR 35.00 16927 231ST AVENUE NW BIG LAKE, MN 55309 STATE SURCHARGE SEWER& WATER 0.50 (763)263-8512 TOTAL 70.50 Minnesota State License#: 2008-6484 PAID WITH CASH 70.50 OWNER BLOMBERG, ANGELA 2660 CASCO PT RD WAYZATA, MN 55391- ACREEMENT AND SWORN STATEMENT The work tor 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 request �n conformance with the State Building Code.This permit may be re e t an � e for ca � ' � - - � l ��l �i�,� �� / l � l U� Applicant Permitee Signature Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , .. FOR CITY USE ONLY ,�0� Clty of Orono Date Received: Permit# P.O.Box 66 ��,, � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed 'a � �;� F Crystal Bay,MN 55323 ��t-��r�o o` (952)249-4600 Approved By(If Required): �A�g08$ CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may require approval by the Bui]ding Official and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aonlication 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. Pernut 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 Pubtic 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) � � � ❑ Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs �isconnect � \ Job Site/ Owner Information: Site Address: c��aC;r' ---�� C'�� , �� ;:.�,�� ,4„ _ ` �,.�d �n Owner: ��,.ra- �� .. � Mailing Address: � City: �rp a�a � � Zip: S��i � Home Phone: Alternate Phone: Contractor Information: � ,� -' ,� ., ....,,K Contractor: �`� ' �.�. ''✓ � 1 !' � �':�'. Contact Person: ��.�",� ..�..� Address: ,��.��'",� :::�`.��'r"`��,��/�s`'Y', State License #: �� '"6�� City: ��,,,�°,,��f`,;� Zip: `��`�'�Expiration Date: ��'�',� �',� , � � , , � Phone: �",�r,� °� ;d�'''° • � ��`�;%. Alternate Phone:C�±f �� , , 6 � �..�',��.� -► , ' e DETERMINTN��"�TT FEES ❑ SAC Charge(2008 Rate=$1,825.00) $ (SAC Charge must accompany all sewer pernut 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($35.00/Per Stub) $ �� Pipe size inches; material Schd 40 air tested; cast iron ❑ Water Connection/Disconnect/Repair($35.00/Per Stub) $ �'"• � Pipe size inches;material Schd 40 air tested; copper 1. SUBTOTAL of Pernut Requested: $ �D � � 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 70, �(� ADDITIONAL INFORMATION—WATER METERS • WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter 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. . � .�� '"' ; � ;� .r"! `�,,,. � �' � Applican ��'°'�-.•..u� .:-'�r�``'�,77"�`�:'-,�.., Date: � ;Y. �— ` � � � ATE TIME V CITY OF ORONO / CALLED IN /� � l�� INSPECTION N�T�� ,/� SCHEDULED PERMIT NO. 7`� COMPLETED �D S/d6 ADDRESS O � - /CL!` v OWNER CONTR S TELEPHONENO. ___ � � --�/� 5��s��7`� � DESCRIPTION lif��`� /�G��v �j��^,�%yt�(.,(l(� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. � COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINA� ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o � � E.°.� D,scc�r Q � Ql� a � � J c w er �J�-s ��.co�_fi c�n�}6 �� 1 W Q �TC� �'iN Z� � a W � W � � d W� �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W�O�CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� GTATION ISSUED ❑ INSPECTIONREOUIRED.CALLTOARRANGEACCESS. Call forthe next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor on site: Inspector. V' T )�� White Copyllnspector's File Canary Copy/Site Notice