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Home My WebLink About2015-01311 - sewer re-connect . CITY OF ORONO * Z 0 1 5 - 0 1 3 1 1 * � 2750 KELLEY PARKWAY DATE ISSUED: 10/09/2015 ORONO, MN 55356- 952 249-4600 FAX: (952 249-4616 ADDRESS : 1105 BROWN RD S PIN : 10-117-23-24-0004 LEGAL DESC : UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RE-CONNECT NOTE: SAC PAID#8752 10/23/86 APPLICANT SEWER CONNECT/DISCONNECT/REPA[R 50.00 STATE SURCHARGE SEWER&WATER 1.00 D.S.M. EXCAVATING TOTAL 51.00 2916 ENTERPRISE AVE HASTINGS, MN 55033- Payment(s) (651)480-1355 CREDIT CARD 0444 51.00 OWNER Norton Homes 18215 45TH AVE N,#D PLYMOUTH,MN 55441- 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 aze ��, requested in conformance with the State Building Code.This permit may be �� revoked at any time for due cause. � r—.,, � �e -9�r v i �,�--�� T, / Applicant Permitee Signatur Date Issued By Signa Date " - FOR CI Y USE ONLY i��0� City Of 01'ono Date Received: G Permit# �/ " ( 11 1' . , P.O.Box 66 I � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ,y� �-j Crystal Bay,MN 55323 �� `��,i,�A�.�{�¢��' (952)249-4600/Fax(952)249-4616 Approved By(If Required): __.__� �r'� CITY OF ORONO—SEWER& WATER/GENERAL PERMIT `e (�'� (•Note:Some permits may require approval by the Building Official and/or Public Works Department') �� ibt� (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is receivedl 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)249-4600,24+hour notice required. TYPE OF PERMIT (Check All That A ply) �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: �� /lOW�✓ /�-4�, Owner: /V0,�1�� ''�� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��c�./Ll. ��-Q'i/�9'r'^'ri 1NL. Contact Person: � l�e Address: Z�l� �N7�/L�Qer6�� State License#: City: Rd��✓GS Zip:S�3 Expiration Date: Phone: ��J` ��6 "�� Alternate Phone: �/Z 9�9 ��1'�' DETERNIINiNG 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 sewer connection permit will not be issued) �Sewer Conn ction/Disconnect/Repair($50.00/Per Stub) $ Pipe size�inches;material��- 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 futwe 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 senarate 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 ardinances 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: �e''9�� . �`�-r �^ CC/�—� ' DATE TIME �L�ITY OF ORONO CALLED IN INSPECTION NOTIC SCHEDULED ��.�� .�'� PERMIT NO2 � �� COMPLETED ADDRESS ( � � � k`�Y�2 ��(�� S• OWNER TELEPHONE NO. �� "� �a f�� CONTRACTOR �S r� ��U- � DESCRIPTION ��'�� G�� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ 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 _ ❑ AS BUILT-SURVEY �EWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE EPTIC INSTALL Z OWNERICONTRACTOR TO MEET YOU: YES_NO c�., COMMENTS: a� a L��o,�s Gc�d � J O �. � O k W � Q � 2 W � W � j d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR W4LL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. GU White Copyllnspector's File Canary CopylSite Notice