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Home My WebLink About2015-01501 (sewer connection) , CITY OF ORONO * z 0 1 5 - 0 1 5 0 1 * 2750 KELLEY PARKWAY DATE ISSUED: 1 U24/2015 ' ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2470 CARMAN ST PIN : 20-117-23-12-0066 LEGAL DESC : LEHMAN LAGOON : LOT 1 BLOCK 1 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER CONNECT[ON APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 DIVERSIFIED PLUMBING TOTAL 51.00 POBOX91 CHASKA, MN 55318- Payment(s) CREDIT CARD 1082 51.00 (763)221-5441 Minnesota State License#: PLUM-71354924 OWNER JARNES,JEFF&JACQ 2470 CARMAN 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. AII 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 construc[ion 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 conform ith the State Building Code.This permit may be revoked at any ti e for d cause. � � ll � i��S pplicant Permitee Signature Date [ssued Signature Date t , FOR CITY USE ONLY ' � �'�`, �` Cl�'Of�TOIIO Date Received: Permit tk _ .,,r.` P.O.Box 66 �, � 2750 Kelley Pazkway ❑In-House SAC Detertnination Form Completed ' `�b � Crystal Bay,MN 55323 `: � ' (952)249-4600/Fax(952)249-4616 Approved By(If Required): CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Oft'icial and/or Public Works Depar[ment*) (ALL PERMl'I'S- Mav be subiect to furt6er review and mav oot be issued when the anulication 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. 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 ezpress approval of the PubGc 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+hoar no6ce 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: �`1�U ��t�e.� ��' Owner: �� ,Sc�'n�,5 Mailing Address: City: (�r�,�c�, Zip: �`�3J Cs2 Home Phone: Alternate Phone: Contractor Information: � l V��S ! L - Contractor: (�1nr,c�l;e, 1 ,c,�es�`naN,�e.r Contact son: Ghcr�+� �,J'i�1nc�3e-� Address: State License#: -�MO(ot1(Day City: (��5�,�--�ip: Expiration Date: a l� � Phone: Alternate Phone: DETERMINING 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) L�Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ C )O� Pipe size_►-�inches;material PVC 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: L Issue Water Meter&Horn Permit 2. Any Addidonal Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ �v=— 2. STATE SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERNIIT 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 s�arate 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 w' ' ances of the City and the regulations of the State of Minnesota,and c ' s tha tateme s made on this application are,true and correct. � Ap ' !`�� Date: � a� s �� v ��- ✓ DAT�// TIME CITY OF ORONO CALLED w � � oZ.`f"'f INSPECTION NO ICE SCHEDULED �==1'�� PERMIT NO. �d��`�co PLETED ADDRESS a�� C�� OWNER ' .T P ONE/� .��I S7��dJ�` CONTRACTOR '��' C/G�L�� f�" � DESCRIPTION C'�JC/� •�G�`��r' [c- ��'(r-�l'L- � W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ 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 _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO v�i COMMENTS: ��'�-�5 � � a �ook s .��o � J O � � O � W � Q � 2 W � W � J d W ❑WORK SATISFACTORY:PROCEED O PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE COYERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDEFi POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS_ Cail for the next inspection 2a hours in advance. (952� 249-4600 OwnerfContractor on site: Inspector_ � �� S � White Copyllnspector's Ffle Canary CopylSfte Notice