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Home My WebLink About2010-00829 - sewer connect CITY OF ORONO PERMIT NO.: 2010-00829 2750 KELLEY PARKWAY ` ORONO, MN 55356- DATE ISSUEu: 09/13/2010 � 952 249-4600 FAX: 952 249-4616 ADDRESS : 3980 CHERRY AVE PIN : 08-117-23-33-0026 LEGAL DESC : CRYSTAL BAY VIEW : LOT 000 BLOCK 005 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPA[R 50.00 KOTHRADE SEWER& WATER STATE SURCHARGE SEWER& WATER 5.00 12059 WHITETAIL AVENUE HANOVER, MN 55341 S.A.C. 0.00 O TOTAL 55.00 Minnesota State License#: 0192 OWNER SCHULTZ, KEVIN 5620 GIRARD AVE N MINNEAPOLIS, MN 55430- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved pians and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does not grant permission for additional or rclated work which requires separate pennits. All provisions ot�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 commcnced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[3uilding Code.This permit may be revoljgd at any time for due cause. ��:�'��-ca�i�� _ � i �� i lC� l i Applicant Per itee Signature Date Issued By nature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . FOR C►TF IiSE OtiLl' �,�Q�O City of Orono Date Received Pennit# P.O.Box 66 � 2750 kelley Parkway ❑In-House SAC Determination Form Completed a • �' Crystal Bay.MN 55323 �'d+ ''�� . o' (952)249-a600 Approved By(If Required): "'Ksexo�� CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (°'Note�.Some permits may require approval by the Buildii�g Official and/or Public Works Departmcnt") (ALL PER�lI7 S- !�9�� be subiect to further review and mav not be issued when the aoplication is receiced) GENERAL INFORMATION I. 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. lssuance 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 I ❑■ Residential (May Require Approval) ❑Commercial(Approval Required) ■❑ New Co��nection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: s�te aaaress: 3980 Cherry Ave (PID #08-117-23-33-0026) oWner: Kevin & Mandy Sehultz Mailing Address: 5620 Girard Ave N Cit : grooklyn Center, MN Z1 55430 y p� Home Phone: �612� 710-4656 Alternate Phone: Contractor Information: Kothrade SWE, Inc. Glen or Pam Kothrade Contractor: Contact Person: 12059 Whitetail Lane Plmbrs Bond 8 Ins Cert#57399MR Address: State License #: Hanover, MN 55341 City: Zip: Expiration Date: Phone: (763) 498-8702 Alternate Phone: (763) 498-0070 DETERMINING PERMIT FEES ❑ SAC Charge(2010 Rate=$2,100.00) $ (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) $ao.00 Pipe size 4" 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. Reauired Before Water Connection Permit is Issued: l. Issue Water Meter& Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Pennit: L Collect Permit Fee& Issue Water Connection Permit 1. SU BTOTAL of Permit Requested: $eo.00 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDL[NG (Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT F'EE(Add Lines 1-3 Above) $ssoo 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 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. %_ "� . Applicant: �-� �� Date: �- (� '/� Reset Form �— /� D/�T TIME �/ CITY OF ORONO CALLED IN � � INSPECTION NOTICE SCHEDULED �-��-/O � PERMIT NO. aO1b"��2� COMPLETED ADDRESS ��BD C��a��nl �� OWNER TELEPHONE NO. CONTRACTOR �OT/1/t� �; DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q ti Z W � W � � � d W� ❑WORKSATISFACTORY:PROCEED ROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED C7 IS UE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WiTNIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. � . � � . � �'n � White Copyllnspector's File Canary Copy/Site Notice