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Home My WebLink About2014-01328 - sewer disconnect CITY OF ORONO * 2 0 1 4 - r� 1 3 z s * �� 2750 KELLEY PARKWAY DATE ISSUED: ll/13/2014 ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1410 CHERRY PL PIN : 08-117-23-33-0081 LEGAL DESC : CRYSTAL BAY VIEW : LOT 000 BLOCK 004 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTG: SEWI�.R DISCONNFC'l� APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER& WATER 5.00 D.S.M. EXCAVATING TOTAL 55.00 2916 ENTERPRISE AVE HASTINGS, MN 55033- Payment(s) (651)480-1355 CREDIT CARD 0444 55.00 OWNER TORGERSON, KEVIN &TGRESA 1410 CHERRY PL MOUND, MN 55364- 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 scparate permits. All provisions of laws and ordinances governing[his typc of work shall be compied with whether or not specified herein.'I'his permil 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 after work has commenced. "I�he applicant is responsible for assurinc all required inspections are requestcd in conti�rmance with the State Building Code.This permit mav�be revoked at anv time r due ca e. / 1�..� 3 -1v G��- i i �� Applic� t Permitee Signature � Date � [ss By Signature Date - FOR CITY USE ONLY y=y��}��' City of OCono Date Received: Pertnit# �� '� P.O.Box 66 �J� ; �t 2750 I�elley Parkway ❑in-House SAC Determination Form Completed ��!/�/ ,:-`\° ' ,, Crystal Bay,MN 55323 �� ""�- , (952)249-4600/Fax(952)249-4616 Approved By(If Required): �`�.,_'�,_.'-,,''; CITY OF ORONO— SEWER& WATER/ GENERAL PERNIIT (*Note:Some permiu may require approval by the Building O�cia]andlor Public Works Departrnent*) (ALL PERMTTS- Mav be subiect to further review and ma��not be issued when the application is received) GENERAL INFORMATION 1. You may apply for utility permits by mail or in person at the City o�ces. 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(9�2-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN Al\�I'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 Water Job Site/Owner Information: Site Address: /�/� �i'��/ I�AG� Owner: �IYEI✓OD�O ��0�25, Mailing Address: City: Gvi4y2�9� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �,S�I�_ �G4U_�N�/NG. Contact Person: /�!/�-� C�4'�'yn'^�� Address: a il� �NY�-D2�.�./�� State License#: �— City: Stl bS Zip: 5��3 Expiration Date: Phone: �S/ 11'SD -/3�5� Alternate Phone: �/2' ��9 y�1/� 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 isconnect Repair(�50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ ��},L Pipe size inches;material Schd 40 air tested; copper ❑Water Availabilih-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 Connection Permit 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 5.00 3. POSTAGE&FIANDLING(Only on Mai]-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL 1NFORMATION—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 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: %�-/�-�� / DATE ty , TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � l �— PERMIT NO. ` � COMPL�� ADDRESS � �� OWNER TELEPHONE NO.��"9�•�� CONTRACTOR DS� � �I'L�K.i �: DESCRIPTION s(ZU�ti �'J�l��i� °'��O-/1s� . � tu ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPT�I/C FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: V YES_NO � CQ�MMENTS: y �r �Q�`��` C� '��+� W a � � O �. � O � W � Q � 2 W � W � j �/`�\WORK SATISFACTORY:PROCEED ❑ PROJECT COMPIEfE ��0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952 j 249-4600 OwnerlContractoronsite: �Sfi'► Inspector. �i'�� White Copyllnspector's Ffle Cenary CopylSite Notice