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Home My WebLink About2014-00332 (sewer & water connection) CITY OF ORONO ' �' 2750 KELLEY PARKWAY * Z 0 1 4 - 0 0 3 3 2 * DATE ISSUED: 04/18/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2625 CASCADE LA PIN : 33-118-23-11-0116 LEGAL DESC : STONEBAY FIFTH ADDITION : LOT 006 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: WA7�I�;R& SGWER CONNI:CTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 T& J CONCRETE STATE SURCHARGE SEWER& WATER 5.00 9100 BALTIMORE STREET NE BLAINE, MN 55449- TOTAL 105.00 (763)413-0988 Payment(s) Minnesota State License#: SW-646112 CHECK ]2865 105.00 OWNER BU[LDERS LI,C, STONEBAY 16135 SSTH AVENUE NORTH PLYMOUTH, MN 55446- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Quilding Code. This permit is for only the worh described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this rype of work shall be compied with whether or not speciYied 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 conslruction is suspended Yor a period of 180 days at any time after work has commenced, l�he applicant is responsible tbr assuring all required inspections aze requested in confbrmance�tiith Ihe State Building Code.�l�his permit may be revoked at any time for due cause. ��`��-c�..� �/��'��y� l��l� Applicant Permitee Signature Date Issu By Signature Date � � . laS, a-r7 �� FOR CITY USE ONL�� Z-��/�� Citv of Oi'000 Date Recei��ed: Permit# �� P.O.Box 66 � 2750 Kelley Pulatiay ❑In-House SAC Detcrmwat�on Fonn Compicted E , : Crystal Bay,vfN 553�3 "��; �:{''� ��, (95�)249-4600 r Fax(952)?49-46I6 Ap}noced By(If Required): "� :,,�,. CTTY OF OROn'0-SEWER& WATER/GENERAL PERMIT (�� 2' �� ("Note:Some per�nits may require approeal Uy dio Build�n$Offiaal andror Public�Vorks Department") (.aLL PERIIITS- 1lav be subiect to furthpr receeN•and mav not be issued�vben the analicatiou is receivedl GENERAL INFORMATION ' 1. You inay apply for utility pemiits by inail or in person at the City offices. 2. Mailed ui applications are subject to the postage and handling fee shown below. Pennit cards will be sent by rehirn tneil within 2 business days. 3. Perinits aee uot vAlid uutit you receive a permit card. 4. Work must not begui wiless d�e pennit card is acailable on tlie job site. 5. Utility coiuiection pennits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600)for utility shib as-built locations. DO NOT EXCAVATE IN Al�'Y STREET A.ND DO NOT TAP Al�Y MAIiV'tir-ithout express appro�•al of the Public V4'ocks Depaitwent. Issuance of a permit does not grant this approval. 7. A!1��ork must be done in accordance witli State Code requirements. 8. All��ork must be uispected before it is covered. Call(952)249-4600,24+hour notice required. TYPE OF PERMIT Check All Tliat A 1 (�Residential(May Require Approval) ❑ Cominercial(Approval Required) �New Cotmection ❑Additionai Connection ❑Re-Coimection ❑Repau�s ❑Discoiuiect ❑ Water At-ailability Conuection For Future Hook-Up to Water Job Site/Owuer Information: Site Address: _ �bo1 Cj �Q�'G�(�Q �y�, Ov�mer:��r� I�S Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor IufoiYnation: � `�.�--rsn� Contractor: �-1� Q{�ld. Contact Person: 1 � � Yhc��hry c. Address: q�(�p �«�yyy��q, �/��C, State License#: City: ��a;(,VLk-- Zip:5�y� Expu•ation Date: Phoue: �3��{�3-bq�g AlteiYiate Plione: (o�a.-6�5 -�j�7 � ! . 1 DETERMINING PERMIT FEES -------��------------ --- _ _ __ _ __ _ .---- -___- --- _ __ _ ____ _. _____---� ❑ SAC Charge(2014 Rate - �2,485.0�) S __--------._---.___---___ �SAC ('li�u•gc iiiusl accoi►ipaiiy alI sewer}�eniiit applicatioi►s uiiless prepaid) (Oroiio C'ity StafTcan deteriiiine it�applicaUle) (If not prepaid,a �ewer connection perniit ��•ill nof be issued) �Se�cer Connection!Disconnect/Repai�S50.00/Pe�•Sinb) S ___ _ ._--___..__-. Pipe sizc. � inches;niateri� do _ Schd 40 air tested; cast irou _ � _ -. [��'ater Connectiou/Disconuect/Repa (�50.00/Per Stub) S Pipe siie � i�iclies: �iiateri•��cl►d 40 air te5ted; co�per ❑R�Ater A��ail�ibilitt�For Future Hook-tip to�'�ater(550.00) $ `�ater:i�-ai(abilit�- Expfanatiou: Contractor installed luie to inside of house for firture hook-up. Tliis liue�vill be inspected t�y the PuUlic Wc»•ks Depariuient Renuired Before V�'ater C'o�viection_PeiYnit is Issued: ? , 1. Issue��l�ater Meter�C, lioni Peniiit ' ' 2. Auy:ldditioual Connection Fees Paid(If Applicable) Issue��l�ater Connectiou Peniiit; ___ _ _ 1. C'oll�ct Penuit Fee�Sc Issue��ater Connectiou Penuit 1. SL"BTOTAL of Pe�tnit Requested: S 2. S"I'A"rF SL'RCI�t�RCiE 5 5.00 3. P(�STAGE fi H.�NDLI\G(Only oci A-f1il-Iii Applications) S ?.00 4. TOTAL PERIVIIT FEE(Add L'nies 1-3�bo��e) S _.T�_ _ __ _._.____--- ---- -----_- — ADDITIONAL INFORI��TION—WATER I�IETERS ■ VVATER i1ZETERS nn�st be picked up and paid for at Qrono City Hall.these are on a s�arate�ermit. ■ �'�:�TER METERS nnist be set and seated b�� Urouo ��'ater I)epart�uent (952) 249-46U0, upou co�upletiou of uieter iustallxtiou. T`lie uiidersigric:d liereby applies to ttic City of'vioiio for issuanc�of�a Ltilily Peiiiiit. a�:rees to do all �vork in strict accordance 4vith the ordinances of thc City and the re�ulatians of the State af �Iiiuiesota, and ceitifies that all5tatements made on this applicatioii are. true uid coirect. Applicant: �'1 �ate: y _I 7-a0 I� � DATE TIME J CITY OF ORONO CALLED IN -` INSPECTION NOTI ,, �c HEDULED — - _!� PERMITNO � ��''L�oMPLETED ADDRESS a�� i��"� OWNER TELEPHONE NO.�/�-��.�a�7�7 CONTRACTOR �N�---C�L/�� ij'I �yS�r1iJ � DESCRIPTION �'`� �`s G�l� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑j OOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB � WATER HOOK-UP ❑ PROGRESS � ❑ FINAL I�SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: PR�Ss��et= rts••-� w�,2� B�T� G�,p W � � J O � � O � W � Q � 2 W � W � J d � WORKSATISFACTORY:PROCEED O PROJECTCOMPIEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnedContractor on site: Inspector. � ..�'��-� White Copyflnspector's File Canary CopylSite Notice