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Home My WebLink About2014-00872 (sewer & water disconnect) CITY OF ORONO . �' 2750 KELLEY PARKWAY * 2 0 1 4 - 0 P1 8 7 2 * DATE ISSUED: 08/12/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3287 CASCO CIR PIN : 20-117-23-43-0044 LEGAL DESC : WINSHIPS SUBD SPRING PARK : LOT 000 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: WA"I�ER AND SGWGR D[SCONNECT APPLICANT SEWER CONNECT/DISCONNECT/RF.,PAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA SEWER& WATER STATE SURCHARGE SEWER& WATER 5.00 6501 CO. RD 15 TOTAL 105.00 MOUND, MN 55364 (952)472-4959 Payment(s) Minnesota State License#: BUIL-1804 CRED[T CARD 5597 105.00 OWNER WRIGHT,JON&KATHLEEN 3287 CASCO CIR WAYZATA, MN 55391- 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 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 no[specified herein."I'his 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the Stat uilding Code.This permit may be revoked at any time for duc ca e. �' �� ,/� ,/�. Applicant Permitee Signature D te Issu d By Signature Date � ' - � ,y� �� v(/ FOR CITY USE ONLY ��[� � /-y�� City�of Orono Date Received: Permit# �y�L�/�—L �r "'�� P.O.Box 66 � �[ � 2750 f:elley Pazkway ❑in-House SAC Determination Form Completed j' �� ,�, � � Crystal Bay,MN 55323 ` '� '�`'�: w� (952)249-4600/Fax(952)249-4616 Approved By(If Required): � ��,��;��"; CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITfi- Mav be subiect to further review and ma� not be issued when the aaplicatiun is received) GENERAL INFORMATION 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 Wate� Job Site/Owner Information: �' G /�' �� Site Adciress: �� o � /�``,C� C �� P Owner:��'� ��C� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��5�°� `�" ��z"'J Contact Person: '��1 �c'�' �I Address: �� ( � State License#: City: �� Zip:��xpiration Date: �.�� -- / � Phone: ��-� ^��-Z- �S � Alternate Phone: V� �—7�� 7 �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/ isconn /Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast iron �Water Connec 'on/Disconnect/ epair($50.00/Per Stub) $ Pipe size inches; Schd 40 air tested; copper ❑Water Availability 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: 1. Issue Water Meter&Hom Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: L 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 INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. ■ WATER METERS must be set and sealed by Orono V�ater 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 n this application are,true and correct. � � � � Applicant: Date: ATE TIME " CITY OF ORONO CALLED IN � �� INSPECTION NOTIC �CHEDULED � �CQ'� PERMIT NO.�� S7 PLETED ADDRESS �U 7 -� � ' L"�fL( � OWNER TELEPHON � � CONTRACT�R � N �,�� DESCRIPTION '�(/ v S �'I.f G�1'�K�G� � W ❑ FOOTING � PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS y Q ❑ 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: '�lJ� d, S� �� cf �'� C.(��/'!o S�j W a � �L'�: /' �� /i� �/ /,�!�P � f �C°��d� �� O � W � Q � 2 W � W � J W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PEHMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WIIL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-46�0 OwnedContractor on site: ��S��'� �t,�r- ,t��-,�- Inspector.��?� White Copyllnspector's File Canary CopylSite Notice