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Home My WebLink About2014-00836 (sewer & water connection) ' ' ' CITY OF ORONO * 2 PJ 1 4 — 0 0 8 3 6 * 2750 KELLEY YARKWAY DATE ISSUED: 08/04/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3759 CASCO AVE P[N : 20-117-23-31-0010 LEGAL DESC : CASCO HEIGHTS : LOT 000 BLOCK 004 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENT]AL CONSTRUCTION TYPE : CONNECTION NOTE: NGW SEWEI2 AND WA��FR CONNECT[ON APPLICANT SEWER CONNECT/D[SCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 GROTH SEWER& WATER STATE SURCHARGE SEWER& WATER 5.00 775 TOWER DRIVE HAMEL, MN 55340- TOTAL 105.00 (763)478-6712 Payment(s) CHECK 16019 105.00 OWNER TONKA DEVELOPMENT 2l6 WATER STREET EXCELSIOR, MN 55331- AGREEMENT ANll 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 E3uilding Code. This permit is for only the work described and does not grant perniission for additional or related work which requires separate permits. All provisions ot laws and ordinances governing this type of work shall be compied with whether or not specitied herein."Chis 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 afier work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Codc.This ermit may bc revoked at any time,lor due cause. � �� /^/ ...J, �{\-t�i ��/ _� / � /f /j Jf�/� /-�� (/ / // / �Applicant P rmitee Signature J ate � Iss e �3y Signature Datc � f , r - /�� F CI USE ONL � ��j -r�y�-�`y�, Cl�'Of OCOIIO Date Receivec��Pernut# �� P.O.Box 66 ? �� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ' �� , . Crystal Bay,MN 55323 �� ''� �,:� (952)249-4600/Fax(952)249-4616 Approved By(If Required): CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT �D�� (*Note:Some pertniu may require approval by the Building Official andlor Public Works Department*) (ALL PERMITS- Mav bc subiect to further review and mav not be issued when the application is received) GENERAL 1NFORMATION 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. Wark 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 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: � % =-'�� -�`/ > �t7 ��-� �� ,/ s ��;� Owner"f�-i S��J`� �./�, ��? < Mailing Address: City: Zip: Home Phone: r:, � � :C �5' ��7 � Alternate Phone: Contractor Information: Contractor: � -> ✓v��, `:� '7` !-%J Contact Person: �'�1�'Y' `7 Address: � 7 S ,1 � �'�� J State License#: City: �-'�'� �' G Zip;,�� Expiration Date: Phone: ��6 3 y 7,� � �/ � Alternate Phone: L.o! z -Z 5�� ' �5 S� S � � DETERMINING PERMIT FEES ❑ SAC Charge(2014 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 /�� chd 40 air tested; cast iron �-Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size_�inches;material�s.�;;-,�Schd 40 air tested; copper i ❑Water Availabilih�For Future Hook-tip 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 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 $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 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 oermit. ■ 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:�-� � � `\� �ATE TIME CITY OF ORONO CALLED IN ��-[ _� ]�+ � i�NSPE�TION IC �SCHEDULED — — __�' �%_.=`�' PERMIT NO. c MPLETED ADDRESS �5 � � � �� OWNER T�L�EPHONE NO.� �'? � � CONTRACTOR �-- v ��J � DESCRIPTION ��/��'�"��' � W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREMIETLANDS y O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑,WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB WATER HOOK-UP ❑ PROGRESS � ❑ FINAL �SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOR TOC�EET YOU:_YES_NO � �� J } //f/'e. � COMMENTS: 6`��R S�/C w'�� '�' r � � ��i' �ti,n� � - � J � a� �" SC�I�o - ��,� s��,�? L� � / , � �'�FifW` . `rj � /� ��/` ��'� �r /s<��✓ Q �� W � W � � � W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED �ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: (�l�/'�' �� Inspector. �l� White Copyllnspector's File Canary CopylSite Notice