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Home My WebLink About2016-00479 (Sewer Repair) , CITY OF ORONO * Z 0 1 6 - PJ 0 4 7 9 * 2750 KELLEY PARKWAY DATE ISSUED: 05/OS/2016 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1416 BALDUR PARK RD PIN : 08-117-23-34-0015 LEGAL DESC : BALDUR PARK : LOT O11 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : REPAIR NOTE: SEWER REPAIR ONLY APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 ROTO ROOTER SERVICES CO. TOTAL 51.00 14530 27TH AVE.N. Payment(s) MINNEAPOLIS,MN 55447- 51.00 (763)519-3907 OWNER MARCIA PETERSON,JEFFREY ULKU/ 1416 BALDUR PARK RD 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 goveming 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 l SO 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 requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � . � _ . � ' �-_ � t- _ . �-v �1 I��v S , S � I� ppl�cant Permitee �gnature ate Issued By Signature Date ♦ FOR CITY USE ONLY n (�r� Q.U/�/O City of Orono Date Received: _!/ _' � Pemut# �1�/(�V I ( P.o.Box 66 /'' i 2750 Kelley Parkway ❑In-House SAC Detercninat�orm Completed � � Crystal Bay,MN 55323 ��1' �Y�'�' ..�^,�`��^ (952)249-46U0/Fax(952)249-4616 Approved By(If Required): 11�� CITY OF ORONO-SEWER& WATER/GENERAL PERMIT ("Note:Some petmits may require approval by the Building Off`icial and/or Public Works Department') (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is receivedl 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�600)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 gant 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: l ��(L�o�c,�r,�r �G�.�%L �rl- Owner: �e�� U � l�v' Mailing Address: /�/� j�Q�i�v,� �,,�,�� City: �r cL�, Zip: 3�S ��,� Home Phone: l�fZ- Z Z(�"' �}(�79 Alternate Phone: Contractor Information: Contractor: �v �r� - �0O'f�r Contact Person: -��i � � , ,.r Address: 145.�C� � 7.� A v,-,/fi' State License #: t'C- ��j y'(�L ( City: Zip: S S-�r��nExpiration Date: � 2/31 � Z o I"� Phone: ��3-�/5-s`i�a 7 Alternate Phone: DETERMINING PERNIIT FEES ❑ SAC Charge(2016 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/Disconnect/Repair($50.00/Per Stub) $ Pipe size�inches;material�_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 Exalanation: 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& Hom 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 $ 1.00 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 for issuance of a Utility Permit, agrees to do a11 work in strict accordance with the ardinances of the City and the regulations of the State of Minnesota, and certifies that a11 statements made on this applicarion are,true and correct. ,./� r% .,- '' �.�:�.._ , . Applicant: � '" =� Date: `� � �lp � .�- � o-t-� � � DATE TIME � CITY OF ORONO CALLED IN INSPECTION NO ICE SCHEDULED � PERMIT NO. �D��p��79CONIPLETED ADDRESS I �"�� l � l-�� /�i�- OWNER TELEPHONE NO. 7�3�Z�6 k � CONTRACTOR ��T� C]2J��_ � DESCRIPTION �J �(�-�er /�-f�-�r � W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z v ❑ DEMO-SITE ❑ PTIC INSTALL 2 OWNERICONTRACTOR T YOU: YES_NO � COMMENTS: �� D// �/f�IC l/Ji�.� SG��i}1'" � � �%;�l" /��'�� j�E,�'�/c��,� Idl� i� ',� o �� ' �it� ��✓� 0_�'� G'� � "��e9��i�;� � � �"� si� 0 � W � Q � 2 W � W � J d W�/��\WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERI'IFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION 1'EMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-460� OwnerlContractor on site: ��' 'V �U�' Inspector. White Copyllnspector's File Cenary CopylSfte Notice