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Home My WebLink About2012-00373 - sewer & water ` CITYOFORONO * 201Z - 00373 * 2750 KELLEY PARKWAY DATE ISSUED: OS/08/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2215 BAYVIEW PL PIN : 17-117-23-44-0026 LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B : LOT 000 BLOCK 000 PERMITTYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECT[ON NO"l'E: WATER&SEWER DISCONNECT APPLICANT SEWER CONNECT/D[SCONNECT/REPAIR 50.00 COPPIN WATER& SEWER 864 QUAIL PKWY WATER CONNECT/D[SCONNECT/REPAIR 50.00 WATERTOWN, MN 55388- STATE SURCHARGE SEWER&WATER 5.00 TOTAL 105.00 OWNER HAZARD,ROBERT&JOHANNE 2215 BAYVIEW PL WAYZATA, MN 55391- 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 separate permits. All provisions of laws and ordinances governing this type of work shall be compicd with whether or not spccified 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 after work has commenced. The applicant is responsible for assuring all required inspections are reques[ed in wnformance with the State Building Code."Chis permit may be revoked at any time for due cause. �[�'--►-.- c:� 5 � 4� � I� � / O / / �� Applicant Permite Signature Date issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. < , FO Y SE ONLY ��f /�2 �/� ,��,�` City Of OrOno Date Received: Permit# �%i��i/ i/ CJv/'— O A `rO P.O.Box 66 � 2750 Kelley Parkway ❑ In-House SAC Determination Porm Completed �'�'��' Crystal Bay,MN 55323 ��tj�;��.yG� (952)249-4600 Approved By(If Reyuired): �O� I(�1 raxos �!/(J CITY OF ORONO— SEWER& WATER/ GENERAL PERMIT (*iVote:Some permits may require approval by the Building OfYicial and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the application is received) GEN�RAL 1NFORMATION 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. Urility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600)for utility stub as-built locarions. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernlit 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) �] 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: l,5 � �I,(� C� Owner: U}�� r�,� �-,,�e� Mailing Address: `_7'� City: Zip: �3f`�`�s rl Home Phone: Alternate Phone: 7�,,� -a6y - �6�r� Contractor Information: Contractor: Cr.��.� ,�� _ (�� u,t�l�� Contact Person: `�\ c��.f� Address: 4�y � ,r�:. nk..�� State License #: 5�7'3,-�ti� i�,�GL City: W�{P(�1rt�;,� Zip:� Expiration Date: t�a_,3�-1 Phone: qSa�-`I�`��1�� Alternate Phone: E1�--S�)S� �`fi�i 7`-� ; DETERMINING rERMIT FEES � ❑ 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 Connecti n/Disconnect/ epair($50.00/Per Stub) $ Pipe size m , Schd 40 air tested; cast iron �Water Connecti /Disconnect/ pair($50.00/Per Stub) $ Pipe size in ;matenal Schd 40 air tested; copper ❑ Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: 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 Connecrion Permit: 1. Collect Permit Fee&Issue Water Connection Permit 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) $ ADDITIONAL 1NFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separatepermit. ■ 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: �� [�,,,n,..�„ Date: � "� — i,� 1 �:7"�'�� T� TIME � CITY OF ORONO CALLED IN �/��i'y INSPECTION TIC CHEDULED O � PERMIT NO ��7 C LETED � ADDRESS OWNER PHO NO. -5b � � CONTRACTOR � , >; DESCRIPTION N� �X/��'�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FO�LOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARO COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: --'�'�� D�S�� c '�<�c�Y �"� �cl�P � a 5-h^�� 3/.�-e,�,�.� � ��e� w � 7�,r'-, 5�",�LJ C � � � O i � �'`J��f-{��— � / 1� 3'Gc�.Y.�E�L 7�Pol �G`� �� ST"� O � W � Q � Z W � W � � d W� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED -1 ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. �� pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '-� CITATION ISSUED ❑ INSPECTION RE(}UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952) 249-46�� OwnerlContractoronsite:��LiC�r�'D��✓ ��4�'-v� Inspector. SC.O'"��'��y��"' White Copylinspector's File Canary CopylSite Notice