HomeMy WebLinkAbout2008-00359 - sewer/water connect � � ! CITY OF ORONO PERMIT NO.: 2008-00359
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuEn: 1U04/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 1470 CHERRY PL
PIN : 08-117-23-33-0017
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 000 BLOCK 004
PERMIT TYPE : SEWER& WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : CONNECTION
NOTE: SAC GRANDFATHERED IN
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 35.00
SCHERBER CO. LLC STATE SURCHARGE SEWER& WATER 0.50
11415 VALLEY DR. TOTAL 35.50
ROGERS, MN 55374
(763)497-I 100
Minnesota State License#: RLI 612074
OWNER
Commercial Mortgage Fund
COMMERC[AL MORTGAGE FUND
8300 NORMAN CENTER DR.#720
BLOOMINGTON,MN 55437-
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
no[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 within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time aRer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in co � mance with the State Building Code.This permit may be
revoked a y ti for e c se.
i � i ��3_ i i
App icant 'tee Signature Date
Issued By Si ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR ABOVE.
r ,�' a
FOR CITY USE ONLY
��� Ctty of Orono Date Received: Permit#
O O P.O.Box 66
; �,y� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed
'�� �'�'�;���- ti Crystal Bay,MN 55323
���^ ��?�c�a��h o~ (952)249-4600 Approved By(If Required):
�4`���
CITY OF ORONO —SEWER& WATER/ GENERAL PERMIT
(*Note:Some permits may require approval by the Building Officiai and/or Public Works Department*)
(ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoplication 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 nof valid until you receive a permit card.
4. Wark must not begin unless the pernut card is available on the job site.
5. Utility connection pernuts may be issued to licensed contractors only.
6. Contact the Public Works Deparrinent(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 pernut does not grant this approval.
7. All work must be done in accardance with State Code requirements.
8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notiee required.
TYPE OF PERMIT
(Check All That Apply)
�Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Connecrion ❑Additional Connection �.Re-Connection ❑ Repairs ❑Disconnect
Job Site/ Owner Information:
Site Address: '�i'�� C�.e�nj �/���
Owner: � �,���I��,�.��.�,,,r,s' Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Sc-��- � � L �C Contact Person: C�� l a� a�a,���./��
Address: /I�(I S v-���e,_ l7,f State License#: Yj ���J�' ��
City: /Zo�c'I'.f Zip:�'�' 7c�xpiration Date: ��— G �
Phone: ��a-a�a'��(�� Alternate Phone: �� � - ��7 —7 ((�a
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.�T��'�:E'�:1��;�PERMIT FEES '�: 3'
� 3i,
❑ SAC Charge(2008 Rate=$1,825.00) $
(SAC Charge must accompany all sewer pernut applicarions unless prepaid)
(Orono City Staff can determine if applicable)
(If not prepaid, a sewer connection permit will not be issued)
�Sewer Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; cast iron
❑ Water Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inches;material Schd 40 air tested; copper
1. SUBTOTAL of Permit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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 instailation.
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 conect.
��
Applicant: Date: �� Tji--o�('
�� �/DAT TIME , /
CITY OF ORONO CALLED IN � ��
INSPECTION NOTICE a SCHEDULED / - -O o2io�0
PERMIT N0.aDO�—�C�.�S/ COMPLETED
ADDRESS ��70 �•
OWNER CONTR. �%�'���� ��
TELEPHONE NO. (O� �'—Z� Z— 7 ���
� DESCRIPTION ��-�'-�c1Pi�, C�G�r U�-✓
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLtNG
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W �d'WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W�❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
inspector. � �
White Copyllnspector's File Canary Copy/Site Notice