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Home My WebLink About2012-00530 - sewer connect ' CITY OF ORONO * Z 0 1 2 — PJ fd 5 3 0 * 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3925 CHERRY AVE PIN : 08-117-23-33-0086 LEGAL DESC : HICKORY HILL : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECT[ON NOTE: NEW SEWER CONNECTION-4"PIPE APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA MECHANICAL INC 6501 COUNTY RD 15 STATE SURCHARGE SEWER& WATER 5.00 MOLJND, MN 55364 TOTAL 55.00 (952)472-4966 OWNER Real Assets LLC 550 25TH AVE N ST CLOUD,MN 56301- 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 permi[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 not specified herein.This permit will expire and become null and void if construction authorized is not commenced wi[hin 180 days of the date of issuance,or if construction is suspended for a period of I 80 days at any time 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 ny time � �e cause. �� ,, % � ��r , (2 - /'�i / L Ap licant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. J , � . �J�. �� FO CI USE ONLY �,�` City of OCono Date Received:�� Permit# 2�/7i�— �� O4 `�`O P•O.Box 66 q 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �.� ��}"� 1�,�,''. � Crystal Bay,MN 55323 � '�'�'�a o 952 249-4600 A roved B If'Re uired '� ��fi�v�y ( ) PP Y( 9 )� t4$asaoa CITY OF ORONO-SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the ao�lication 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. 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 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 Apply) ,QResidential(May Require Approval) ❑ Commercial(Approval Required) �New Connection ❑ Additional Connection ❑Re-Connection ❑ Repairs ❑ Disconnect ' ❑ Water Availability Connection For Future Hook-Up to Water Job Site/ Owner Information: ,�- • < ' '' Site Address: � �� _�«�� ; �--�� Owner: ,�7'�. �� TC y��Sc>�t f-l�t�S Mailing Address: City: Zip: Home Phone: Alternate Phone: � Contractor Information: Contractor: L�-`'��'�1�� S�c �:� Contact Person: �.��"��`` 1 �� <�� Address: - f�� - �� State License #: City: ��LL��`��L Zip:S�j��`� Expiration Date: Phone: ��5�- � ��- L�l � l Alternate Phone: �� - �� . �� '�` �;_ " �"�;� '� ��D�TERMINING'PERMIT FE£�� `� ❑ SAC Charge(2012 Rate=$2,365.00) $ (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/Re�air($50.00/Per Stub) $ Pipe size �� inches; material x� 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 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&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connecrion Permit 1. SUBTOTAL of Pernut 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 Water Department (952) 249-4600, upon completion of ineter installation. The undersigned hereby applies to the City of Orono far issuance of a Utility Permit, agrees to do all wark in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifie_ s�at all statements ma�dn thi plication are,true and correct. , --" , Applicant: ��- �� Date: —�� _ � � � D E TIM E ✓ CITY OF ORONO CALLED IN � / � INSPECTION NOT CE SCHEDULED �� PERMIT NO. �/L-� C PLETED ADDRESS OWNER TE ONE N `�� `��- �7�� CONTRACTOR >; DESCRIPTION '�vv� � Ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL O SEWER HOOK-UP ❑ COMPLAINT � ❑ 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: � W � o ( i •A �.3' �j� �u �3 ��-- '' � ,� � �,- � v� I �-- � 0 � W � Q � Z W � W � � GW ❑WORKSATISFACTORY:PROCEED f�R�iOJECTCOMPLETE � ❑CORRECT WORK&PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice