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Home My WebLink About2015-01544 (sewer & water disconnect) � CITY OF ORONO * Z 0 1 5 - 0 1 5 4 4 * 2750 KELLEY PARKWAY DATE [SSUED: 12/10/2015 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3185 CASCO CIR PIN : 20-117-23-43-0024 LEGAL DESC : SPRING PARK : LOT 034 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: WATER&SEWER DISCONNECT APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 COPPIN SEWER&WATER WATERCONNECT/DISCONNECT/REPAIR 50.00 864 QUAIL PKWY STATE SURCHARGE SEWER&WATER 1.00 WATERTOWN,MN 55388- TOTAL 101.00 Minnesota State License#: SW-57329MR Payment(s) CHECK 4730 101.00 OWNER YAFFE,HARRY&BELLE 2300 ARCHERS LA MINNETONKA, MN 55305- AGREEMENT AND SWORN STATEMENT The work for which[his permi[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 separate 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 construction authorized is not commenced within I80 days of the date of issuance,or if construction is suspended for a period of 180 days at any[ime 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. ^ /�. � �� v /a-, /� �/5 Applicant Permitee ignature � Date Issued 'gnature Date � �� FOR IT US ONLY '�yc �" ��NO Cit)'Of OCOIlO Date Received� 0 Permit# d�(�i..J� ✓ P.O.Box 66 ! � 2750 Kelley Parkway ❑In-House SAC Determmat�on Form Completed �, i ., Crystal Bay,MN 55323 "�` �,�� (952)249-4600/Fax(952)249�616 Approved By(If Required): :.,.;,,, CITY OF ORONO—SEWER & WATER/GENERAL PERMIT (*Note:Some permi[s may require approval by the Building Official and/or Public Works Department*) (ALL PF,RMITS- Mav be subiect to further review and mav not be issued when the anolication is received) GENERAL INFORMATION 1. You may apply for utility pennits 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 ANl'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 l � (�Residential(May Require Approval) ❑Commercial(Approval Required) ❑ New Connection ❑ Additional Connection ❑Re-Connection ❑Repairs �Disconnect ❑ Water Availability Connection For FutuXe Hook-Up to Water Job Site/Owner Information: Site Address: 3�, � _S L�,.�,�n ;� Owner:l��'� `(�,F�� Mailing Address: `�� !�`�oh��S L� City: lu;�,� k;�kv. Zip: ��O � Home Phone: �,��-��`7 ��jl� Alternate Phone: Contractor Information: � Contractor: CqQ_��%�L�QL} ��p! Contact Person: (��\��-�.� Address: 4�(�{ £�'�,;,� :rC � State License#: ��- /►1� City: 1�c9c�21�� Zip�� Expiration Date: �,—�\— \� Phone: (o`a'SC�-�'�'��1�1� 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) ❑ 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 inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water(550.00) $ Water Availabilitv Exnlanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. R�ce uired Before Water Connection Permit is Issued: 1. 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 $ 1.00 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00 4. TOTAL PERMTT 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 sevarate permit. ■ WATER METERS must be set and sealed by Or000 Water Department (952) 249-4600, upon completion of ineter installarion. 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: ��,- l(� ' � � b / n\� �� \1 / DATE TIME �'CIN OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED PERMIT NO. ��S ��54y COMPLETED ADDRESS � � �� --- OWNER TELEPHONE NO. ��Z SOB�'`��7� CONTRACTOR � /�/�7�l��V � DESCRIPTION ,_, � �� -� lL ❑ 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 i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ EPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO c�.� COMMENTS: a ��1.1��' t�t, ,.�L� L. � t�j ,�.� � � � � � v�� '� L i �-� �`,� �' ,�.,� �i 0 � W � Q � 2 W � W � J W,�1NORK SATISFACTORY:PROCEED `'C�PROJ ECT COM PLEf E � ❑CORRECT WORK 8 PROCEED ❑ fSSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARV � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP OFDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 torthe next inspectior�24 hours in advance. (g52) 249-46�� OwnedContractor on site: �� Inspector. �`+�•�l7 White Copyllnspector's File Canary CopylSite Notice