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Home My WebLink About2008-00193 - sewer & water connection p , �' CITY OF ORONO PERMIT NO.: 2008-00193 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssvEv: 09/08/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 795 BRIDGEWATER DR PIN : 33-118-23-12-0020 LEGAL DESC : STONEBAY FOURTH ADDITION : LOT 009 BLOCK 001 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW WATER AND SEWER INSTALLA"I'ION. APPLICA1vT SEWER CONNECT/DISCONNECT/REPA[R 35.00 GROTH SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 35.00 775 TOWER DRIVE HAMEL,MN 55340- STATE SURCHARGE SEWER&WATER 0.50 (763)478-6712 TOTAL 70.50 Minnesota State License#: 058606-PM OWNER _ O.T. Development,LLC LLC,O.T. DEVELOPMENT, 2670 KELLEY PKWY ORONO, MN 55356- 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 reques[ed in conformance with the State Building Code.�hi permit may be revoked a any for due cause. � i � �� Applicant Permitee Signature Date Ys ed By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC IB ABOVE. � � , � FOR C[TY L'SE ONLY ¢Q,�` City of Orono Date Received: Permit# `r P.O.Box 66 �"� � 2750 Kelley Parkway ❑ In-House SAC Determination Form Completed a �� Crystal Bay,MN 55323 �+� � �` ��i�o o (952)249-4600 Approved By(If Required): �asso$` CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT (*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 application is received) GENERAL INFORMATION L You may apply for utility pernuts 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 pernuts 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 pernut 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-Connecrion ❑Repairs ❑Disconnect Job Site/ Owner Information: � �� Site Address: ) � ' �s2 �2 � Owner: C%L1 G i��`� Mailin Address: Jc- �i g City: Zip: Home Phone: Alternate Phone: Contractor Information: ,�-� 1 � � � � Contractor��--��"� `� �`�'� �� Contact Person: � Address: � � (�C�� State License#: �� _ City: �=�/,� Zip:�s�/ �xpiration Date: J `- � �� Phone: �� , 7� � �/� Alternate Phone: (� ` � �� C/� . ) - . �� . , �� . n �� , ` �� P � ' .. g� ��A `: � f >a � ❑ SAC Charge(2007 Rate=$1,825.00) $ (SAC Charge must accompany all sewer pernut applications unless prepaid) (Orono City Staff can deternune if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Connec ion/Disconnect/Repair ($35.00/Per Stub) $ Pipe size�inches;material�j;�Schd 40 air tested; cast iron U " `� �Water Connection/Disconnect/Repair ($35.00/Per Stub) $ Pipe size�inches;material Schd 40 air tested; copper �,� 1. SUBTOTAL of Pemut Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL 1NFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate vernut. ■ 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: � - � � � \�— �> � T TIME +� CITY OF ORONO CALLED IN S� INSPECTION NO/�ICE C� SCHEDULED U //-�4v�C)� PERMIT NO. ��/ � l/� COMPLETED ADDRESS .�J� OWNER CONTR. ��U� �i(�ti S TELEPHONE N0. �` � �� '� 7�3 7��0 7� �� DESCRIPTION y Q�� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ITREE 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 FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J �� I� � � O � W � Q � Z W � W � � d W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ ORRECT WORK&PROCEED '� ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN �NSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-Q6QQ OwnerlContractor on si : Inspector. � � � White Copy/inspector's File Canary CopylSite Notice