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Home My WebLink About2015-01192 (Plan Review) CITY OF ORONO * 2 0 1 5 - P1 1 1 9 2 * 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015 r • -� ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1400 BALDUR PARK RD PIN : 08-117-23-31-0001 LEGAL DESC : BALDUR PARK : LOT O15 BLOCK 001 PERMTT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 600,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$600,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE PERMIT#T'HIS PR�PAYMENT IS TIED TO:20 1 5-0 1 1 93 APPLICANT ADVANCED PLAN REVIEW 2,700.48 E.S.HOMES TOTAL 2,700.48 13170 UTICA AVE PSyment(s) SAVAGE,MN 55378- 2,700.48 (612)239-43 L7 Ci ty of Orono 2750 Kelley Parkway Minnesota State License#:BUIL-20638592 Orono MN 55356 952-249-4600 Receipt No: 3.014234 Sep 17, 2015 OWNER ELLIOTT, STEVE ES Homes LLC 1400 BALDUR PARK RD WAYZATA,MN 55391- Previous Balance: .00 Permits 2015-01192 1400 Baldur 2,700.48 Park Rd AGREEMENT AND SWORN STATEMENT 1U1-34410 The work for which this permit is issued shall be performed according to P1 an Check/Si te Exam Fees the approved plans and specifications,applicable City approvals,and the _______________ State Building Code. This permit is for only the work described and dces Tot81: 2,700.48 not grant permission for addirional or related work which requires separate --------------- permits. All provisions of laws and ordinances goveming this type of work --------------- shall be compied with whether or not specified herein.This permit will CheCk expire and become null and void if construction authorized is not requested in conformance with the State Building Code.This permit may be --------------- revoked at any time for due cause. Change Tendered' .UO --------------- --------------- 09/17/2015 10:11AM / Applicant Permitee Signature Date Issued By Signature Date . � CITY OF ORONO * z 0 1 5 - 0 1 2 0 7 * 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2015 ORONO, MN 55356- (952 249-4600 FAX: (952) 249-4616 ADDRESS : 1400 BALDUR PARK RD PIN : 08-117-23-31-0001 LEGAL DESC : BALDUR PARK : LOT O15 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 E.S. HOMES TOTAL 51.00 13170 UTICA AVE Payment(s) SAVAGE,MN 55378- 51.00 (612)239-4317 Minnesota State License#: BUIL-20638592 OWNER ELL[OTT, STEVE 1400 BALDUR PARK RD 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 goveming 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. - �� . !�. =�%�`� �L% `1 �"1��L' (� � � � i � � C Applicant Permitee Sign re Date Issued By Signa ure Date . ��+ 1 ' FOR C TY U,.E ONLY .,�.^� ��"' i�.-0/1T \ City or Orono Date Received: � ermit# � 1;'�' � 1 � 'ti P.O.Box 66 �-� I ( � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ; ; � ;' C stal Ba ,MN 55323 �Y Y / `y``��¢F�j (952)249-4600/Fa�t(952)249-4616 Approved By(If Required): /�, �.�`(� �..kES.H` .`"� G J \ CITY OF ORONO-SEWER& WATER/GENERAL PERMIT ��i (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) � (ALL PERMITS- Mav be subiect to further review and mav not be issued when the auolicallon is received) GENER.AL 1NFORMATION 1. You may apply for utility permits by maii or in person at the City of�ices. 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 Deparnnent(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approvai 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) [�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: /�G � (�a L�� f � � (� /�o cz � Owner: �T�� l�«�'t Mailing Address: ��d?-� �oc Lc,.�u l� ��fi!C !� City: �i�_,t� O Zip: ,� Home Phone: �J Z Z f-U�?�� Alternate Phone: Contractor Information: Contractor: � F��-t� /l� Contact Person: ��e-� �P�.�P�,C/.9 �zl�o�� U� � Address: ?� State License#: /�� 2,�`��'2 City: �� Zip•t'� ��/�kpiration Date: �j. O�! � 2 �O� � Phone: �( 2 - 2�`�. �3 f 7 Alternate Phone: DE`TERM�ITNG PERMIT FEES ❑ SAC Charge(2015 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 sewe ction permit will not be issued) � �-, ♦ �Sewer Connection/ isconue�"t Repair($50.00/Per Stub) $ �� Pipe size inches;material Schd 40 au 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 Availabilitv Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Reauired 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 l. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 1.00 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 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. Applicant: - Date: �q'•. �� ^29��s�