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Home My WebLink About2014-00114 (sewer-disconnect) ' CITY OF ORONO * 2 0 1 4 - 0 0 1 1 4 * ' 2750 KELLEY PARKWAY DATE ISSUED: 02/OS/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3225 CASCO CIR PIN : 20-117-23-43-0021 LEGAL DESC : SPRING PARK : LOT 029 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER& WATER 5.00 STONEWOOD, LLC TOTAL 55.00 153 E LAKE STREET WAYZATA, MN 55391- Payment(s) (612)462-4000 CHECK 12499 55.00 Minnesota State License#: BUIL-BC594315 OWNER LEESTMA, MARTIN& KATHRYN 3225 CASCO CIR WAYZATA, MN 55391- AGREEMENT AIYD 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 gran[permission for additional or related work which requires separate permits. All 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 180 days of the date of issuance,or if construction is suspended for a period of l80 days at any time after work has commenced. The applicant is responsible for assurine all required inspections are requested in conformance with the State Building Code.This permit may be revoked at an time for e cause Z-- S- /� / / App � ant Pe mitee Signat Date [ssued Qy Signature Date <- i t ;.: FOR CITY USG ONLY��7v �D O/�� .. /:��1�1�-.,�� Cit3'Of 01'Orio Date Received: Permit# � '� P.O.Box 66 ? � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ' � ; Crystal Bay,MN 55323 i } 'o'��_�"� � ��J (952)249-4600/Fax(952)249-4616 Approved By(If Reqwred): �` � CITY OF ORONO— SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official andlor Public Works Department*) (ALL PERMITS- Mav be subiect to further revieN�and ma��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 of6ces. 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 oot valid until vou 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]icensed contractors only. 6. Contact the Public Works Department(952-249-4600)for utility sCub 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 ) r _ ' � 'd ntial(May Require Approval) ❑ Commercial (Approval Required) ew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: �Z� ��G,�c�-�. - Owner:Ie�dn/�� ..�-. Mailing Address: City: I�Srv-r� IM�� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��y`.'C,�,�n . 1-F•C Contact Person: , S , Address: 1�3 L�e 5��-+�.'� � . State License#: �C-S��3� ` City: Cr1 k�,A�� Zip: ��N Expiration Date: Phone: Q�2 25d �+� Alternate Phone: �' 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 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($50.00) $ Water Availability Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Rec�uired 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: $ � a� 2. STATE SURCHARGE $ � 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ '�J�7 • �v .-�— ADDITIONAL INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a se�arate permit. ■ 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 Ciry of Orono for issuance of a Utility Permit, agrees to do all work in strict acco c with the ordinances of the City nd the regulations of the State of Minnesota,and c ifies t a atements made � this ap ' ation are,true and correct. lic Date: ��Z � � �� DATE TIME ✓ CITY OF ORONO CALLED IN � �Z� INSPECTIOND��TIC SCHEDULED — � PERMIT NO.�(J � COMP ED '-" ADDRESS OWNER T€.L.EPHON� NO. — ` CONTRACTOR �� J � DESCRIPTION ��C��-C�C- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. � FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO ti COMMENTS: S��, Gv� l�i S C'c� n�'J G C� /Oc�5� G��'�Z- a �%�c,.� n j p,,� $O�'�'-- T iJ Y'ti a��'K ��7� o �� a_� r � ��,, ��-r i��s �-��- � �T��, �� p�� Tv �we�� s��r- 0 � W � Q � 2 W � W � J d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERT�FICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: _..._. Inspector._ White Copyllnspector's File Canary Copy/Site Notice