The URL can be used to link to this page

Home My WebLink About2009-00294 - sewer/water disconnect ' '�`' CITY OF ORONO PERMIT NO.: 2009-00294 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/09/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3447 CRYSTAL BAY RD PIN : 17-117-23-43-0122 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTiON TYPE : DISCONNECTION NOTE: WATER AND SEWER DISCONNEC"i' APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 COPPIN PLUMBING WATER CONNECT/DISCONNECT/REPAIR 50.00 8460 COUNTY RD 15 M[NNETRISTA, MN STATE SURCHARGE SEWER& WATER 0.50 �6iz�24o-6z2o TOTaL ioo.so Minnesota State License#: 58745 OWIVER NO KNOWN OWNER AGREEMENT AND SWORN STATEMENT The�vork for which this permit is issued shall be performed according to thc approved plans and specitications,applicable City approvals,and the State Building Code. This pennit 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 compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within l80 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 reque in confonnance � h the State Building Code.This permit may be rev ed t any time for ue cause. � � ' / /U� / / Appl ca t Permitee ig Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � FOR CITY USE ONLY �,�` City of Orono Date Received: Permit# O4 `rO P.O.[3ox 66 i �;.„, 2750 Kelley Parkway ❑ In-House SAC Determination Form Completed a ��`6?�' Crystal Bay,MN 55323 �A��.�o� (952)249-4600 Approved By(If Required): o$ CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PER:VIITS- Mav be subiect to further review and mav not be issued when the apn��cation is received) GENERAL INFORMATION 1. You may apply for urility permits by mail or in person at the City offices. 2. Mailed in applicarions 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. 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 Apply) ❑ Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs isconnect Job Site/ Owner Information: Site Address: � � � � '`�^ �� ' �� `� � � �` Y Owner: 1 ��' \' \Cl� 1�` �-i +� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: � Q Q•j (� S'�'`-' Contact Person: `-�a Yl C:..� Address: � l b� C�-7 Q� ( S State License#: � � 7 � � City: �u � 0.' Zip:��3S`) Expiration Date: �� 3 � " O � Phone: �S o� `�7 .�- ' � �i 7 � Alternate Phone: �o � � o� T d (� �.,,2 � DETERMINING PERMIT FEES ❑ SAC Charge(2009 Rate=$2,000.00) $ (SAC Charge must accompany all sewer permit 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($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 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 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 separate pernut. ■ 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. , � � , Q � Applicant: ' Date: J V� h � — � �� TE TIME V CITY OF ORONO �iN � d`� INSPECTION NOTICE � �HEDULED � a PERMIT NO. o7L�G '�J'-�ao2y7"coMPLETED �� ' ADDRESS 7 OWNER CONTR. ` �� TELEPHONENO. ��- �T� - � d /� � . � DESCRIPTION �/�� `Y �'�� Cr � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 v ❑ DEMO-FINAL ❑ SEPTiC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � d W� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ��CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY � ❑CARRECT 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 ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next ins ection 24 hours in advance. (952� 249-4600 OwnerlContra o e- Inspecto White Copyllnspector's File Canary CopylSite Notice