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Home My WebLink About2016-00642 (Sewer) r � CITY OF ORONO � 0 1 6 - 0 0 6 4 2 * ' 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1400 BALDUR PARK RD PI I� : 08-117-23-31-0001 LEGAL DESC : BALDUR PARK : LOT O15 BLOCK OOl PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER CONNECTION-4"PIPE, SCH.40 APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 WESTONKA SEWER& WATER TOTAL 51.00 6501 CO. RD 15 Payment(s) MOLIND, MN 55364 51.00 (952)472-4959 Minnesota State License#: BUIL-1804 OWNER ELLIOT"I', STEVE 1400 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 specitications,applicable City approvals,and the State E3uilding 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 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 18o days at any time afrer 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 a�time for due cause. r � � -�_ O �l � � � � I� Ap icant Permi gnat e Date Issued Signature Date � . �—O-. FOR ITY USE ONLY � �l /„ �/ �� O� City of Oroao Date Received:b"�'/[�Permit# � � v �Y �` '; P.O.Box 66 2750 Keiley Parkway ❑In-House SAC Determination Form Completed ��5 � Z-�` Crystal Bay,MN 55323 \``\��.�4j j (952)249-4600/Fax(952)249-4616 Approved By(If Required): CITY OF ORONO-SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- Mav be subiect to further review and mav aot be issued when t6e aoolication is receivedl GENERAL INFORMATION 1. You may apply for utility permits by mail or in person at the City of�ices. 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by retum 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 Departrnent(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 PER1VIiT (Check All That A 1 g] Residential(May Require Approval) ❑ Commercial(Approval Required) ( " j� New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑ Disconnect � ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: n Site Address: � FJ �� ' -��r e�"� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: C Contractor: �� "� � Contact Person: ��`� —`�� Address: ��'� � - � � State License#: �! /' City: �C�-��'� Zip:�J�`-'�Expiration Date: Phone: �'�{?�-� �� Alternate Phone: � ��-7��-�77 � ► . DE'I'EI�:�✓IIl�IN�PERMTT FEES ❑ SAC Charge(2015 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/Rep�r($50.00/Per Stub) $ Pipe size C�inches;material_�Schd 40 air tested; cast iron ❑ Water Connection/Disconnect/Repair(550.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑ Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: Contractor instalied line to inside of house for future book-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 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) S �%�" ADDITIONAL INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate 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 far issuance of a Utility Permit, agees 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 o is application are,true and correct. �, Applicant: / Date: � � �/� � � � � ` DATE TIME � CITY OF ORONO CALLED IN INSPECTION NO ICE scHE�u�Eo '� i(,� ____t=�`_` PERMIT NO. -� 1'� �COMPLETED ADDRESS ��! C.�C' I�C l c��:'' /�/L �l� OWNER TELEPHONE NO. CONTRACTOR S ' C ��'1 �i/ T S�f � DESCRIPTION ��"�'�� ^ ll� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL�7 //7r.� � 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 _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�i COMMENTS: C�GL�-� 'c� �i 6'1 '!'.�-�-/ � C 7G�a�yy�z/� � ' / a `7�� /l7LZ.� �.,t / 7�G r C��' � J 0 >. � 0 � W 2 Q � 2 W � W � � � r�vRKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W/ ❑CORRECT VYORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDEH POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: Inspector. .1/C;'�/ White Copyllnspector's File Canary CopylSite Notice