HomeMy WebLinkAbout2014-00523 (sewer & water connection) � CITY OF ORONO * 2 0 1 4 - PJ 0 5 2 3 *
2750 KELLEY PARKWAY �ATE [SSUFu: 05/29/2014
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& WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : CONNECTION
NOTE: WATER& SF;WrR CONN�CCION
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00
WATER CONNECT/DISCONNECT/REPAIR 50.00
COPPIN WATER & SEWER STATE SURCHARGE SEWER&WATER 5.00
864 QUAIL PKWY
WATERTOWN, MN 55388- MAIL-IN FEE 2.00
TOTAL 107.00
Payment(s)
CREDIT CARD 5597 ]07.00
OWNER
LEESTMA, MARTIN & KATHRYN
3225 CASCO CIR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
t�he work ibr which this permit is issucd shall be perfonned according to
the approved plans and specitications,applicable Ciry approvals,and the
State I3uilding Codc. This permit is for only thc work described and does
not grant permission for additional or related work which requires separatc
permits. All provisions of la���s and ordinances governing this type oFwork
shall be compied with whether or not specified herein.This permit will
expire and bccome 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 oY 180 days at any time after work has commenced.
Thc applicant is responsible for assuring all required inspections are
requested in conformance widi the Statc Buiiding Code.This permit may bc
revoked at any time f�or due cause.
� S 2`l � � ���u a-�. � �Z�, i�
ilpplicant Permitee Sign ure ate Issucd y Signature Datc
May 29 14 08:24a Westonka Mechanical 952-472-4961 p.1
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�'�O/�r � City c►f Orono n�Ruer�cd: Y�,.�_
i� � �, r.o.ser�F '�
� � 2750 Kellay P�'�'aY ❑t�Ha+�e SA D 'on Forta Ccm+p�cmd
, CryataS$r.y.N1N 55323
�.1�,'��,.'• (v52)2a9-rGDo/Fa�c(952)244�6]6 AWmved By(If Roqalrcd):
�E�i�
Cj'fY OF OROIVO—SEVi�.R 8c WATER 1 GENEItAL PERMIT
�*ryqh;$ov,�pvrniey m�y reqninc sppro.al bv thc BniEding Officisl and�o!PUMic Works Departrnrnt h
fAS.L �7l'1S M De ailbi�a m futdlysf rcvkw� d m�v�M b�io�ued w4en 4b�ids�Nnn i�LLCI1�)
GEN.�AL iNFORMATIO�i
1, You may appJy for ucitiry perrnits by�nail or in pecsnn st thc Ciry offccs.
Z. MailCd lfl dpp�}catiOtlS 0.re�bjCct tv the post2�gc ard h�dling fee shown btlow. Permit CSids will
bc sen�by retum mail withm 2 bus.i��-t days.
3. Pern,itq�►re not valid nntil vou rccefvc�perwit card_
4. Work mu�t nat begin unte.�c the pennit card is avaifa6lt on tbe jab sitt,
5. Lltility com�ection permiss may bc issucd to liccnsed contracton only.
6. Contact the Fublic Work�Dcpartm.ent(952-249�4�0)for ublity stub as-built locativns,
DO Np�EXCAwA'�E IN AN1'STREE�'AIy'I3 I30 NOT�'AP ANY MA.�T tvith�vt expresa
npproval of the Pltblic Works X3epartaaeirt. �uancc of a permit docs no��trant this approval.
7, All work must be done in accordance with 5[ate Code rcqui�emazts.
8, A,11 wark muss bc in�ecsed befo�e it is coverecf. Gali(952)249-4Ci00,24+hour natict required.
TYPE Ok'.PERMIT
Check All.7'hat A lv
�R�identiai(May�tequire Ap�proval) ❑Commercia](Approval Requirad)
�New Conncction ❑Additiona3 ConRection ❑Re-Cannection �Repasrs ❑Disconnect
❑ Vdacer Avai Iability Canneetion For Fu[ur�f[ook-Up to Wa�er
Jab Site/Owne�'�nfomiatioz�
�
Si�e Address: _��� � � �C� � ��r�" �
Owt�er.���l"�C7'u G` Mailing Addreqc:
City: Zip:
Home Phone: Alternate Phone:
Cantractar ln��.rmation: '
, 1
) r /
Contractor: �1 �f � �'n ���''���Contact Persen: �Y 1 � /�
Address: C�� ��`� ��� tate License�:
� ef��.�n . s���
Ciry' Zzp: Ex�i,ratzon Dste,
�'j� � JG��—��� Altemate Pho�e� �?io4 '�J��—�
Ph�n�: ' /
�
May 29 14 08:24a Westonka Mechanical 952-472-4961 p.2
CJ��LD/ Gqlv Cr1:10 7�CL�174b1U E,1 I Y Uh' UKUf'�U NH(]t b1/bl
� �ETERNiININ�G PE�I'T FEES
Q 5AC Chirge(Z0�4 Rabe=5�2�485.00) S
(SAC Ghargc m.ust acco�trpariy all sewer permit apptications uniess�re.�aid)
(Omno Ciry 5[af�can �ece*nzmc if7lppiicable)
(l£aat prepRid,a�ew¢r connectialn permit w(1)not be isaued)
�Sewer Conn on/Dil�onnect/Repair{$SQ.QO/F'er 3tab) S
Pipe t�ze�inci�es:matcnal`�5chd 4Q aiz usced: c�rt iron
�Water Conneetinu 1 Tlivm�necc I Rcpxir(5513.00/Per Stub) �
��� TApe size�inches;material ,�C/Schd 44 air testEd; capper
,��
0 Water Av■;l■bitity For F�tare Aook-lip t�Water(35(IAO) S
Water Avu'It�bilitv E�[plagatian:
Con'.raccor in,s!allcd iine to inside of housc far future hook-up_
Tfiis linc wiI[be inspccted by thc Public works Departmen�.
�Lequiced Before Water ConncctiogFermit is Is�u�d:
1. Issue Wa*.er I�eter&Hom permit
Z, p,,ny qddi�ooal Connccdan Fecs Paid(.[f Applicabls)
I55uC Watef COil11CCLQn PcSmti:
,, Collxt Pe-mit Fce&Ixsue Wa�er Connectian Permit
1. SUBTOTAL of PermiG�equestcd: �
2. STRT'E SrJRGHARGE S 5.06
3, P05TAGF&}�.4I��D�TNG(dr11y an Mail-In Applicatiat;s) $ 2.04
4. TOxAL PERM�'i'FEE(Add Lines 1.-3 Above) S
AI3DI'I�O.NAL TN�+4.R1'v1ATI0N—WATER METERS
■ WATER M'E'TERS:nust be pick�d up and paid for�.I Orcmo Cily K�SJ,theSC eTC OA a,c�,epargte ot_CrX3i1.
• WATL+R h�.ETERS mu9t be aet 8nd sealed bp OrOt�o W�ter Dtprrtinent (952) 249-d600, npon
eompLetioAt otmeter islstallation.
'I'hc undersigned hereby applies to tbe City of 4rono for issnAnce c•f a Uri�ity Pe�it,s�rees to do
a1a work in stn�ct aecordance with the ord�nanccs of t]�e City and ihe regulations a�t3+e State of
Mitinesota,and certifies thaC a]I stptements mede vn thic applicatiom are,true a�d correcr.
App2ieartt_ � Date� 1 �' -��,~
�� � TIME "
CIN OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED -��
PERMIT NO.eZ���—Do5�'.� COMPLETED - -I
ADDRESS 32 Z 5 C(S�-D t�/
OWNER TELEPHONE O.
CONTRACTOR S�' d
� DESCRIPTION ���'i" wGCX_Y�l�
�
� ❑ FOOTiNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
y ❑ POURED WALL ❑ MECHANICAL RI ❑ L4KESHORENVETLANDS
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION /�❑ OOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB /�i I�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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS: �(.�" � � � /✓
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W RKSATISFACTORY:PROCEED O PROJECT COMPLEfE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 haurs in advance. (,�52� 249-46�0
OwnerlConUactor on site: � ��
Inspector. � ` �v
White Copyltnspector's File Canary CopylSite Notice