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Home My WebLink About2015-01370 - sewer disconnection CITY OF ORONO * z 0 1 5 - 0 1 3� 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2015 � ORONO, MN 55356- - 952 249-4600 FAX: 952) 249-4616 ADDRESS : 1224 BRIAR ST PIN : 10-117-23-31-0074 LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE ; LOT 000 BLOCK 002 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: SAC PAID#8279 OUO2/1986 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 TUMA CONSTRUCTION TOTAL 51.00 5045 COUNTY ROAD 19 M[NNETRISTA,MN 55359- Payment(s) (763)479-2982 CHECK 4679 51.00 Minnesota State License#: BUIL-PB695614 OWNER HILLIER,JAMES 1224 BRIAR ST 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 sepazate 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 80 days of t date of issuance,or if construc[ion is suspended for a r od of 18 ay at any time r wor a�rnenced. The applicant' r ponsib for s�ci�- r red inspections are requested in o ormanc wit he S[ate Bu' ' g Code.This permit may be �7��7 revoked at ime for ue ause. � �G-z�-l�� - ��1 �' �� (�� 3� ! Appl cant Permitee Signature Date Issued By Signature Date Y l�r �- �', FU��.7` USE ONLY * ,��0� City Of OrOno Date Received: Per�nit# -� � 's P.O.Box 66 � 2750 Kelley Parkway ❑I�-House SAC Determination Form Completed �y� �-j Crystai Bay,MN 55323 \\��s`i�¢ti�� (952)249-4600/Fax(952)249-4616 Approved By(If Required): c�C� � Sj,� CITY OF ORONO-SEWER& WATER/GENERAL PERMIT � Z`�� (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent') (ALL PERMTfS- Mav be subiect to further review and mav not be issued when the anoticaHon is receivedl GENERAL INFORA�IATION 1. You may apply for urility permits by mail or in person at the City of�ices. 2. Mailed in applications are subject to the postage and handling fee shown below. Pemut cards will be sent by rehun 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. Urility 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 A 1 �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: � 2' Z'� f�(r J e�c/ �v � Owner: Mailing Address: City: b v�a�` v Zip: Home Phone: Alternate Phone: Contractor Information: Contractor:�-�� a v a f. Contact Person: C �"' l / !.c� � `c`� �t �, ! � Address: ��S �oµK �y� State License#: �I3 CQ qS�Lo!�--f � � City: ��t K-cfh.'�f� Zip:3� 3'�Expiration Date: (Z--3��- �� Phone: ��Z '�Y-S'�S'',� Alternate Phone: n DETERMINTNG PERMIT FEES � ❑ SAC Charge(2015 Rate=52,485.00) $ (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 Connection/ isconne Repair($50.00/Per Stub) $ Pipe size inch • erial 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 Availabilitv 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&Hom 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 $ 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 se�arate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter installation. The undersigned reby app 'e o for issuance of a Utility Permit, agrees to do all work in stri t ccorda c with e ordinances of the City and the regulations of the State of Minnesota, a c rtifies t all s ements made on this application are,h-ue and correct. A licant: t2 � �v� 2 �— �S pp JDate: � C� li� DATE TIME CITY OF ORONO CALLED IN �— INSPECTION NOTICE SCHEDULED 1L��'"—��-��— PERMIT NO.�1�� 37C COMPLETED ADDRESS �� y ��zh- �, OWNER TELEPHONE NO.�� r �� CONTRACTOR (-�_�'YC�— � DESCRIPTION b, �J'P� ,�� 1��1/'111G�" lL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP w ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z J ❑ DEMO-SITE ❑ EP IC INSTALL 2 OWNERICONTRACTOR TO MEET YES_NO c�.� COMMENTS: � � � � r�v<� V�t 5 cv✓�� c fi p GOU/�r � �1 h � �. � O � W � Q � 2 W � W � j � /'�WORKSATISFACTORY:PROCEED �PROJECT COMPLETE W{�❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR NIILI REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 24J-46�� OwnerlContractor on site: Inspector. � ""'"�"—�� White Copyllnspector's File Canary CopylSite Notiee