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2012-00682 - sewer
> - ' CITY OF ORONO * z 0 1 Z - 0 0 6 B 2 * 2750 KELLEY PARKWAY DATE ISSUED: 07/17/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3980 DAHL RD PIN : 08-117-23-23-0001 LEGAL DESC : UNPLATTED 08 1 17 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: SEWR DISCONNEC"1'-4" PIPE -SCHEDULF,40 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 J S STEWART COMPANIES, INC. STATE SURCHARGE SEWER& WATER 5.00 1]099 LAMONT AVE NE TOTAL 55.00 HANOVER, MN 55341 O PAID WITH CC# 8391 OWNER MCGLYNN, THOMAS&TON[ 3980 DAHL RD MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perYormed according to the approved plans and specifications,applicable City approvals,and the Sta[e Building Code. This permit is for only the work described and docs 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�i�i[h whe[her or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the�ete of issuance,or if construction is suspended for a period of I 80 y at any time after work has commenced. T pplic t is respo t le y�ssuring all required inspections are quested i confor nce e Building Code.This permit may be revokcd any ' or � ause. _ � l-G ? l I � � � / pplicant Permitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. FO CIT USE ONLY nJ ,��� Clty of Orono Date Received� o�—Permit# (�� ' �(�/� P.O.Box G6 ��;;,.ti � 2750 Kelley Parkway ❑ In-House SAC Determination Form Completed � �1'������,�. !� Crystal Bay,MN 55323 t�������d�� (952)249-4600 Approved By(If Required): CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may rcquire approval by the Building Official and/or Public Works Department*) (ALL PERMITS- Mav be subicct to further review and mav not be issued when the annlication is received) GENERAL 1NFORMATION L 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 pernut 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 loeations. 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 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 Far Future Hook-Up to Water Job Site / Owner Information: Site Address: ���� !.;.Y-}1-}(_._, ¢�-� _ Owner: �c'- �`�i�G�/ Mailing Address: ��'�y� t�r9HC- f� City: L/(��!-O Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: J S 5'c�L�?(�� �PArV i�S Contact Person: J�, G't�l, ��J�9(-� Address: ��d J� �1Ylc�-��/�'� State License #: City: vV� Zip:``j�`�� Expiration Date: Phonee ?4�3 �Z4 ��%'.�� Alternate Phone: �IZ 3� �v '�'�� r H DETERMINING PERMIT 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 Conne tion/Disconnect/Repair($50.00/Per Stub) $ �w 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 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 Addirional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ 5b . �� 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5J�• � 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 compietion 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 c � .es that all statemen made o �s application are,true and correct. Applicant: Date: ( ��� ��Z � DA TIME ✓ CITY OF ORONO CALLED IN � � � INSPEC�I'iON NOTICE SCHEDULED 7 �-- � PF.�'iMIT NO.�-l56(dRa-- COMPLETED ADDRESS ��.�S� ��-�Y ��tr�f�-- OWNER TELEPHONE NO.����I CONTRACTOR � '�-���� ��� /lil �; DESCRIPTION �� ��SGOYI h � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � �� C�p m�� �,,,��,.-, 3 /z ��- o �� S,�we.- L�� S'�� .�.✓. a � 0 � W � Q � ~ �e ��'Tv�� /h� { " Z � r�i -P W S� � � � a W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN . ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advanc�g52) 249-46�� OwnerlContractor on site: -�-5 S'��W''g�i� Inspector. S�� White Copyllnspector's File Canary CopylSite Notice ' � �j.� �'� ...�4 i ,�yrPo s '�' � � `y'� ;"�"�i n','�.� '"�� # �'� A"s ., ` �.,�.. � � .4+�r'ti Y!► x.. '�'y.a , y, � .. . . �.� p�""�,�� � ;�,�' pi '" ' ' _' ,�`«'�:� '�" , , � � " � ,� . � „ � . . � �,,�,"�{ �< �s . :.. , . •;' �� �� �� '� ' � ► �. .�� ,. . .�� , d ... . :9� . 'Y� . � i , • , ' . "�a��s� 4.._ ' �.. �^V'�h+ f `Y" n°.} . . i � 4� . ,' ,. � �s. ' �. ' ' • " 4 �^ " _vi : K. " .�"� e? r}`�. t .A.,�. 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