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Home My WebLink About2016-00188 - disconnect only �, CITY OF ORONO _ � 2750 KELLEY PARKWAY * Z 0 1 6 0 0 1 8 8 * DATE ISSUED: 02/29/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1735 FAGERNESS POINT RD PIN : 17-11'7-23-22-0034 LEGAL DESC : MAPLEGATE INLET : LOT 001 BLOCK 002 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: SAC PAID#3209- 1976 D[SCONNF,CTION ONLY APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 WATERCONNECT/DISCONNECT/REPAIR 50.00 PRIDE CONSTRUCTION&EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 9450 WEST HILL ROAD WATERTOWN, MN 55388 TOTAL 101.00 (952)475-2928 Payment(s) CREDIT CARD 1822 101.00 OWNER WILLIAMS,TONEY&CHRIS 1735 FAGERNESS PT RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMEIYT 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 rype of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 1 AO days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[3uilding Code.This permit may be revo at any time for d ause. � 3� � � �g�/� pp an Permitee igna ure Datc Issued ignature Date .�..� `��r. �� . � G�' � %'—�"'� TUR CIT1'USE ONLY �� City of Orono Dace Rece�vea: %-7�-/(- permit# %L l(c-_C� � (�c/ ', P.O.Box 66 ' !� � ; 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �J �,z� �j Crystal Bay,MN 55323 � _/ �,\,�A��¢,�.� (952)249-4600/F�(952)249-4616 Approved By(If Required): - � l�� r -�7� CITY OF ORONO–SEWER& WATER/GENERAL PERNIIT /�'7�� (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMTTS- Mav be subiect to further review aod mav not be issued whea the auolicallon is received) 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 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 cazd 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 MAIlV 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+hoar nr„ice required. TYPE OF PERMIT (Check All That A l �Residential(May Require Approval) ❑ Commercial(Approval Required) l ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs isconnect ❑ Water Availability Connecrion For Future Hook-Up to Wat� Job Site/Owner Information: Site Address: .�� C ` «' ' , Owner: �� G(/i��Ct� Mailing Address: / � '�//jp1-�'S �� ( City: ��( Y E'�'�1"� Zip: .��— � Home Phone: � Alternate Phone: Contractor Information: �//�� ,CG��/�CTii�s� Contractor: ��(,P'G ��l!' ,�f'J � Contact Person: �r,!'� //'I�� Address: �y� ��'��i'/� �� Sta e%i'cen e#: � �gZg��/�� City: (�'"�r��'�� Zip:�-��xpiration Date: '-�- Phone: ,��Z�S�Z��L Alternate Phone: �.�Z�yy,b -b'��Z 1 , DETEIt1bIIlVIN�i PERMIT FEES ❑ SAC Charge(2015 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Or o City Staff can determine if applicable) not prepaid,a se,wer�o nn ectic��permit will not be issued) Sewer Connection/D�necL-/-R�pair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast iron �}'�'Vater Connectio lDisconnect/Repair($50.00/Per Stub) $ Pipe size �ches;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: l. 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 s�arate 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 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. ,�� '� j� �� , A lican . � �C:�" � �' , � ..�t--� Date: � rr � � .�i� � � ,,�� /� • DATE TIME OF ORONO CALLED IN _�_ INSPECTI NOTICE(\ SCHEDULED I l �_ PERMIT ��"v� COMPLETED ADDRESS � �"�� `�� '� I�A. OWNER TELEPHONE NO.��~ ��-'�J CONTRACTOR j►�1 C�� C�S� � DESCRIPTION S�J,-� �,t �cG41� 4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ 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�� ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY SEWER ��re�UP�S�❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: r`�;5 e�hw.e�— S �..�e-,� d— w��'�i' � GOril<t� ca-rc%�/ � �l✓��' S��✓'�✓', �c/�'�.. oF�= O �-x �C c v i 't�:1 � . nvST C7Y� 13�%`�- I/�Irs �. � � �,� y �� ,� j�;�-�:� �� W � Q � 2 W � w � j O W� '�"OVORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W a CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: ,� Inspector. �/-� �— White Copylinspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.,.,2 C�KO ' CX�t Sf fl COMPLETED ADDRESS �� ll'111� I�� OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION ��/ � ( � . — ly ❑ FOOTING � � Q ❑ POURED WAL! _ING y ❑ FOU�'�� e ❑ RAI � � �C � �� ❑ FRi � � ❑ INS Q ❑ FIN W ❑ AS �� AL J ❑ DEI �� Q OWNEI � COM � l�- S� �G <(�v/ _ � �� '� -ec�� 0 � � �. � 0 � W � ///�G/ � Q � � 2 W W � J d W ❑WOF � ❑COF �NCY W O ❑COP V BEF ❑COP ❑STO O INSF Ca11 forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector: White Copyllnspector's File Canary CopylSite Notke