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Home My WebLink About2009-00694 - sewer/water connection , ! w CITY OF ORONO PERMIT NO.: 2009-00694 2750 KELLEY PARKWAY ORONO, MN 55356- DATE [ssuE�: 10/12/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 1981 FAGERNESS POINT RD PIN : 18-117-23-14-0005 LEGAL DESC : FAGERNESS : LOT 004 BLOCK 000 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NO']�E: SEWER CONNECTION-4" PIPE SIZE, PVC MATERIAL WATER CONNECTION- 1"PIPE SIZE, POLY MATERIAL APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 R[TTER EXCAVATING WATER CONNECT/D[SCONNECT/REPAIR 50.00 7120 VERNON STREET ROCKFORD, MN 55373 STATE SURCHARGE SEWER&WATER 0.50 (612)477-5649 TOTAL 100.50 Minnesota State License#: 1921 OWNER WHITTINGTON-GGROENKE, M[CHEAL&JULIE 1981 FAGERNESS PT RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT "I'he work Yor which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State I�uilding Code. This permit is for only the wark 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 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 revoke�at �time � du cause. ! , � � / /L� / / A ' ant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. ♦ � FOR CITY L'SE ONLY �} ��9� ,��,�` City of Orono Date Received: Permit# (/�� "r P.O.Box 66 �', � 2750 Kelley Parkway ❑ln-House SAC Determination Form Completed �,,;� � � 1`' Crystal Bay,MN 5�323 �,� ��'� 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 W"orks Department*) (ALL PERMITS- Mav be subiect to further review and mav not be issued when the application is received) GENERAL INFORMATION 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 perniit 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 accardance with State Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600, 24+hour ootice required. TYPE OF PERMIT (Check All That Apply) �esidential(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: � � �S � �c;(s-�z SS ��. \�'� Owner: Mailing Address: City: �J��G Zip: Home Phone: Alternate Phone: Contractor Information: Contractor:��c,.c�.� �_��e� (��u„c��Contact Person: ��-� Vec.�,;�� S-�, Address: � �'�-U ( �c�n,�.� State License #: City: ��C�-��c� Zip:�S3'�,`Y�j Expiration Date: Phone: �v �,),- �(c(- (�f I� 1 Alternate Phone: . , I DETERMTNING PERMIT FEES ❑ SAC Charge(2009 Rate=$2,000.00) $ (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 L� inches; material 1'��- Schd 40 air tested; cast iron o� (�.Water Conn�e ion/Disconnect/Repair($50.00/Per Stub) $ SC.� � Pipe size�__inches;material c� Schd 40 air tested; copper �J��( ❑ Water Availability For Future HookLUp to Water($50.00) $ Water Availabilitv Exnlanation: 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 Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit U� 1. SUBTOTAL of Permit Requested: $ +�7� 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 2.00 a S� 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � j l7 � �- 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 iostallation. 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. � - Applicant: ticB � Date: �� '� � � � (�J_ DAT TIME ✓ CITY OF ORONO CALJyE��i�r� -3 U INSPECTION NOTICE scr4�6QE� � PERMIT NO�vZ� '�'!—��ct COMPLETED ADDRESS �� OWNER NTR. - TELEPHONE NO �� '��/ ��—, _l�1 L , �� DESCRIPTION �� /��G�L- � ❑ FOOTING ❑ MECHANIC RI ❑ EXCAV/GRADING/FILLING Q ❑ FR,4MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL �WER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � W r! I C_,r' /� n ct .�� . � �2��-�^ ,ti y c t�c� a � o , , � � J�.�. ;� i � �1� (.-f A> .q �. . v � w Q �}'f c u� � �' �# .t�N 1�� i -}�f'C- z ��`�1�� i��tiJ �� ..�•�j ��`� , W � W � � d � ❑WORK SATISFACTORY:PROCEED i f�IpROJECT COMPLETE W ❑ CORRECT WORK&PROCEED '� 18SUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CAL�FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED C INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contractor on site: � Inspector. ^ ' ;-�--) White Copyllnspector's File Canary CopylSite Notice