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Home My WebLink About2012-00472 (sewer & water disconnect) CITY OF ORONO * Z 0 1 2 - 0 0 4 7 Z * ., 2750 KELLEY PARKWAY DATE ISSUED: OS/30/2012 � - ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3165 CASCO CIR PIN : 20-117-23-43-0026 LEGAL DESC : SPRING PARK : LOT 036 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 BOLLIG& SONS, INC. WATER CONNECT/DISCONNECT/REPAIR 50.00 1 1401 COUNTY ROAD 3 HOPKINS, MN STATE SURCHARGE SEWER&WATER 5.00 (612)938-4433 TOTAL 105.00 OWNER ARMSTRONG, WARD&KATHLEEN 6898 EDGEBROOK PLACE EDEN PRA]RIE,MN 55346- 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 permissio�y€er,additional or related work which requires separate permits. AII pr sions f laws and ordinances governing this type of work shall be com 'ed with hether or not speciYied herein.This permit will expire an ccome n 1 and void if construction authorized is not comme ithin�80 days of the date of issuance,or if construction is suspe d f r a pe�od of 180 days at any time after work has commenced. The plic nt i nsible for assuring all required inspections are re co orm nce wi[h the State Building Code.This permit may be r ke a an im � / / / / p� t rmitee Signature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. , FOR CIiY USE ONLY +,,;¢0�� CityofOrono Daueeceived: Permic� s �1 P.O.Box 66 �� 1 2750 Kelley Partcway ❑In-Housc SAC Deumtirmtion Form Completed '`��,s, r3 Crystal Bay,MN 55323 �;�r:�a o��' (952)249�600 Approved By(if Requited): �¢'y� CITY OF OROlvO-SEWER 8c WATER/G�;NERAL PERMIT (`Note:Somc permits may rrquire approvat by the BuiEdieg OfficiaJ anNor Public Works Department') {AI,i,PERMI'I'S- Mav be aa6ictt to fuHhcr revNx and mav not bc isaacd wben the sndicatio4 a r`eteived) GENERAL TNFORMATION 1. You may appty for utility permits by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shoum below. Permit cards will be sent by retum mail within 2 business days. 3_ Permits are not valid unt�l you receive a permit card. 4. Woric must not begin unless the permit card is availabie on ihe job site. 5. Utitity conne.ction pertnits may be issued to licensed canVactors only. 6. Contact the Pubtic Works Departrnent(952-249-4600)for utiiity stub as-built tocations. DO NOT EXCAVATE IN ANX STREET AND DO NOT TAP ANY MAIN wit6out e:press appraval of the Pubtic Warks Departmeat. Issuance ofa permit does not grant thes approval. 7. All werk must be done in accordance with State Code requirements. 8. All work must be inspecied befo�+e it is covered. Calt(952)249-4600,24+6our notice required. TY�'E OF PERMIT (Check All That t1 1 ❑Residential(May Require Approval) ❑Commercia)(Approva!Required) ❑New Connection ❑Adtlitionai Connection ❑Re,Connection ❑Repairs D�sconnect ❑ Water Availability Connection For Future Hook-Up to Wa Job Site/Owner Information: Site Address: ��5 {„�'��;Y'" Owner'�v�c{ '/,�,✓'. V'v Mailing Address: �9a' $E� P� ►2t�,� J��a,c� ciry: �4jPu. N�?��'-�'e 11�t/� zip: �3'� �v Home Phone: �a- p`��-O�(o� Alternate Phone: �o�a '�f '�3� �C e�� Contractor Information: Contractor: /' 1�.��z Contact Person: C/�' ��`�� ''� Address: l/�d/ '�� '.z....�j�3 State License#: �lJ�.- 1GN+d'3 #�� r / City: /� �i� _ Zip�S�y3Expiration Date: 02�8��/ Phone: �S� ��1�.� Alternate Phone: t-�'e��'"735� . DETERNIINING PERMIT FEES ❑SAC Charge(2012 Rate=$2,365.00) S (SAC Charge must accompany all sewer permit appiications unless prepaid) (Orono City Staff can determine if applicable) (if not prepaid,a se rnnnection permit wili not be issaed) �ewer Conaectio /Discounect/Repair($50.00tPer St�b) S Pipe size in es;mate' Schd 40 air tested; cast iron [�Water Connectio /Disconnect Repair($50.00/Per Stub) $ Pipe size i ches;m af Schd 40 air tested; copper ❑Water Avaiia6ility For Futare Hook-Up to Water(550.0{}) $ Water Availabilitv Explanatipn: Contractor instalied line to inside of house for future hook-up. This line will be inspected by the Public Works Department Rec2uired�foce Water�onnection Petmit�s Issued: 1. Issue Water Meter&Horn Permit 2. Any Additiona(Connection Fees Paid(If Applicable) Issue Water Connection Permit: i. Collect Permit Fee&Issue Water Connection Permit 1. S13BTOTAL of Permit Requested: $ 2. STATE SURCHARGE � 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TUTAL PERMIT FEE(Add Lines t-3 Above) S ADDITIONAL INFORMATION-WAT£R MET�,RS ■ WATER METERS must be picked up and paid for at Orono City Hall,these aze on a separate permit • WATER METERS must be set and sealed by Orono Water Depgrtment(952)249-4600, apon complction of ineter instaltstion. The undersigned hereby applies to the City of Orono for issuance of a Utility Pertnit,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. ApplicanE:�� Daie: `S/a� �a' � Reset FOrm P/� D TE TIME v -- �o�� CITY OF ORONO ✓� CALLED IN 5 INSPECTION NOTICE^� SCHEDULED � /� PERMIT NO.�oia�C..�/�� COMPLETED �� p ADDRESS -3llPS C�G{/I Gr) C��.�� i OWNER ELEPHONE NO��?�2�I'73 � CONTRACTOR�S�1�� - �� DESCRIPTION � w � S�O� �LQ� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEE7 YOU:_Y� � COMMENTS: l � � � W a � J O /-�/�J'j �. L. ��'vL�`/vtL � 0 � Y� � S �� ✓� w � Q zt,,,< < (� /1�� r�.ti2 � (, ��...�2 ,� � S �,�7 t,� � �-� ��u�-� /��-✓� � � a � WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspecti n 24 hours in advance. (952� 249-46�� OwnerlContractor o it Inspector. White Copyllnspector's File Canary CopylSite Notice