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Home My WebLink About2015-00721 (sewer & water connec.) CITY OF ORONO * z 0 1 5 - 0 0 7 2 1 * 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2015 , ' ORONO, MN 55356- (952) 249-4600 FAX: 952 249-4616 ADDRESS : 2490 CARMAN ST pi� : 20-117-23-12-0065 LEGAL DESC : LEHMAN LAGOON : LOT 2 BLOCK 1 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SAC PAID#2014-01488 05/27/15 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 D.S.M. EXCAVATING TOTAL 100.00 2916 ENTERPRISE AVE Payment(s) HASTINGS,MN 55033- CREDIT CARD 0444 100.00 (651)480-1355 OWNER Lakeshore Holdings LLC 153 E LAKE 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 dces 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. -� /Z G 7 " ° ��g--1� � = r C';� � r r i � i /S Applicant ermitee Signature Date Issued y Signatur Date F�33F.ONLY ��i Clty Of�1'OItO Date Received: � Permit# C� `� C' 7�-� � P.O.Box 66 �1 2750 Kelley Parkway ❑In-I�ouse SAC Determination Fortn Completed , � , � Crystal Bay,MN 55323 „ ``�'�, � � (952)249-4600/Fax(952)249-4616 Approved B (lf R uired : r* r . T,,�tf�>�> Y �t ) —� �� ,��`b/ CITY OF ORONO— SEWER& WATER/GENERAL PERMIT ��,L�`� .�L1��`� (*Note:Some permits may require approva]by the Building Ot�cial and/or Public Works Department*) ��.�,r/ (AI,L PF,RMITS- Mav be subiect to further review and mav not be issued when the aoolication 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 Depart�nent(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE 1N 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 befare 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: �y9d �'9�tAn/ S7; Owner: �i✓�k2�'� ,8�02�5 Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��5,/11,�'_:l.'�V��✓L ��v�. Contact Person: : ��a 9�9 y3��3 Address: r�91� ��'rt�.�,i� �� State License #: City: ��✓GS Zip: �5'�D3J' Expiration Date: Phone: 1e�'/� �i'�'fD - /�3s'S-� Alternate Phone: �/� g/9 �/3y� DETER.MINING 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 Connection/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 f`�L inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: 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 Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Pennit Requested: $ 2. STATE SURCHARGE $ 5.00 3. POSTAGE& HANDLING(Only on Mail-ln 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 Qermit. ■ 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: ��'/� DATE TIME�% CITY OF O�iONO CALLED IN S-'S INSPECTION N T��7�� SCHEDULED �-S-/S /•' 3-O PERMIT NO. cOMPLETED � ADDRESS �. ��'� ��fiY`'y�L'I1��'/ ��J/r L� OWNER TELEPHONE NO. CONTRACTOR �`5� �t - �u!/'��,�` � DESCRIPTION �� l� ❑ FOOTWG ❑ DEMO-FINAL ❑ SEPTIC FINAL C�/��G�d 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 �VATER HOOK-UP ❑ FOLLOW-UP �U ❑ AS BUILT-SURVEY �SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO . c�., COMMENTS: I �� v� �� a � � � � i � � 9 � �e, G�LG¢ � c� � ,tr F�.�' c,��r� S'� o- �x�' IZ � 0 � W � Q z '� S�,� �10 �Pv L SP��,s- .��. � -�i�CPr �!/�t� '� �� l� �r' -�'_'�f �! -e r.- l' S f1�iLu�1�3 �� WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDiT10N WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52 j 249-46�0 OwnerlContractor on site: �'��'a1 �L��/� Inspector. `� /� White Copylinspector's File Canary CopylSite Notiee