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Home My WebLink About2014-00733 - sewer/water connect f . CITY OF ORONO * 2 0 1 4 — 0 0 7 3 3 * 2750 KELLEY PARKWAY pATE �SSUEn: 07/1U2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2975 CASCO POINT RD PIIY : 20-117-23-31-0045 LEGAL DESC : SPRING PARK : LOT 089 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTI�: N1;W Wn"I1;R&SEWER CONNI�',C'I'ION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 BOLLIG& SONS, INC. STATE SURCHARGE SEWER& WATER 5.00 11401 COUNTY ROAD 3 HOPKINS, MN TOTAL 105.00 (612)938-4433 Payment(s) CREDIT CARD 6881 105.00 OWNER GOODWIN, KURT& BARBARA 7310 KURVERS POINT ROAD CHANHASSEN, MN 55317- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to thc 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 goveming this type of work shall be compied with whether or not speciYied herein.'I'his perrnit will expire and bccome null and void if construction authorized is not commenced within 180 days of the date oCissuance,or if construction is suspendcd for a period of 180 days at any timc afrer work has conuneneed. I'he 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 eause. � �� i�l � npplicant Permitee Signature Date Issued y Signature Date — FOR CTI'Y USE ONLY %��/�/� City of Orono Date Received: Permit# P.O.Bax 66 /1' - 2750 Kelley Parkway ❑tn-House SAC Determination Form Completed �) Crystal Bay,MN 55323 '�� '� (952)249�600/Fax(952)249-4616 Approved By(If Required} 9A/�II�iP�`` CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Departmen[') (ALL PERMITS- Mav be subiect to further review and mav not be issued when the anolication 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. Pernut 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 Warks 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 �esidential(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 Info�mation: SiteAddress: � ! � �`�� i�� v Owner: ��n�' vV��U Mailing Address: c��: W�Y Z�� z�p: ��1 � Home Phone: ��l ��b� G��uU Alternate Phone: Contractor Information: , (� � Contractor: ��I I I� `�5��', Contact Person: C ��'" �) l p � � Address: I I�I�` G� "� J State License#: �b City: �� Zip:' 1�I� Expiration Date: •' 1�_1 I "�� f� Phone: - I`�a ��" C��3 Alternate Phone: �I�Y �� I 7c70" �nS �e(,��1 �r- �a-� ,. /V�o��,�� h{ l�l}� � ��r n��n U�,,�� a'�3� DETERMINING PERMIT FEES ❑SAC Charge(2014 Rate=$2,485.00) S (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connecNon permit will not be issued) ,�Sewer ConngFtion/Disconnect/Repair($50.00/Per Stub) $ Pipe size�� inches;material Schd 40 air tested; cast iron �Water Con ction/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 Availabilitv Explana6on: 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: 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 Pernvt 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) $ ADDITTONAL INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a seaarate pernut. ■ 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 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. � A licant: r � � +� Date: � ��/ � �I rr �Se� / �/ DAT TIME CITY OF ORONO CALLED IN � — INSPECTION NOTIC SCHEDULED a� PERMIT NO. �7� COMP�ETED ADDRESS OWNER TELEPHONE NO. � — � CONTRACTOR \` � DESCRIPTION � w`�``��'eC"'"� W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB WATER HOOK-UP ❑ PROGRESS � O FINAL SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVA� v ❑ PLUMBING RI ❑ SEPTIC FINAL � FOUNDATION/REMOVAL 2 OWNERICONTFiACTOR TO ME�iYOU:_YES_NO � COMMENTS:` � �, �(�,�fT��v v .`S�-C��c�� /_ a __J��,r ` f,��'� "�� f/" �P� o �� Q��. � ° ;�� /`y �n.:�p ��^ ,�a�.�� 3/i�� - Q �vrd 5�.� � W � � � W � � � /C�WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE �` O CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: l�Z�� s�� Inspector. � � �� White Copyllnspector's File Cenary CopyfSite Notice