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Home My WebLink About2016-01378 - sewer/water disconnect CITY OF ORONO * Z 0 1 6 - 0 1 3 7 8 * � 2750 KELLEY PARKWAY DATE ISSUED: 10/3U2016 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2649 CASCO POINT RD PIN : 20-117-23-24-0029 LEGAL DESC : SPRING PARK : LOT 138 BLOCK 000 PERMIT TYI'E : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTE: DISCONNECT ONLY APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 WATERCONNECT/DISCONNECT/REPAIR 50.00 CHUCK'S EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 760 WEST 96TH STREET CHANHASSEN,MN 55317- TOTAL 101.00 (952)496-2874 Payment(s) Minnesota State License#: SW-L3�20 CREDIT CARD 8989 101.00 OWNER K1NDL, DUSTIN&CASIE 2649 CASCO PT 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 specifications,applicable City approvals,and the State[3uilding 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 goveming this type of work shall be compicd 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 die 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 Slate Building Code.This permit may be � revoked at any time for due cause � 1 �_ � ��.� ��1� �,, � , � . : � �c� `�� /� Applicant Permitee Signature Date Issucd By S gnature Date . � � C��3 � Fox�us�oivi,� f��NO� Clty Of OCono Date Received: Permit tl �� `, P.O.Box 66 �' � 2750 Kelley Parkway ❑In-I�ouse SAC Determination Form Completcd ��'pl'U1 ,�-f Crystal Bay,MN 55323 �p \\��S�i o¢,�� (952)249-4600/Fax(952)249-4616 Approved By(1f Required): ^ / "' CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent") (ALL PERMTI'S- Mav be subi�ct to further review and mav not be issued when t6e aoolication is receivedl GENERAL INFORMATIOl�i 1. You may apply for utility permits by mail or in person at the City offices. 2. Mailed in applications aze 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 cazd is available on the job site. 5. Urility 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 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 PERNI�T' Check All That A i �Q Residential(May Require Approval) ❑ Commercial(Approval Required) ✓ � ❑ New Connection ❑Additional Connection ❑Re-Connection ❑Repairs Disconnect ❑ Water Availability Connection For Future Hook-Up to Wate Job Site/Ovvner In�o�ation: Site Address: � �� ( ��'D C n��h� �� Owner: Mailing Address: City: (/�D/�8 ��r� Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��l.��'k� �k � Contact Person: �G,��+�/� Address: �� In/ ��7�ST State License#: L. �,3�� City: �h � a� Zip:Z5�17 Expiration Date: ��-� Phone: �� ,�/� � `� z� Alternate Phone: �S� ��o ��7� . � D� ' P�I�vIIT 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/Repair($50.00/Per Stub) $ � �Pipe size inches;material Schd 40 air tested; cast iron Water Connection/Disconnect/Repair($50.00/Per Stub) $ _ ipe size inches;material Schd 40 air tested; copper ❑ Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: Contractor installed line to inside of house for future hook-up. T'his line will be inspected by the Public Works Departrnent. 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. Coilect 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 l-3 Above) $ ADDITIONAL INFORMATiON—WATER METERS ■ WATER METERS must be picked up and paid for at Orono Ciry 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 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. / / A licant: � i� Date: / D � 3� — �l0 rr .----- _--- DATE TI CITY OF ORONO CALLED IN �C:-�/-�� INSPECTION N ICE�137 SCHEDULED /� -�/-lb � PERMIT NO. ' � � COMPLEfED ADDRESS lo� �-�GL � �� OWNER _ /' T�EPHONE NO �a ag� CONT�ACTO� �� -� Q- Va--� � DESCRIPTION �� s � �y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/C,RADING/FILLIN� 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 �Y ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z v ❑ DEMO-SITE ❑ SEPTIC INSTALL ? OWNERICOKTRACTOR TO MEET Y�OU:_YES_NO .. � COMMENTS: �ll �`'l� � �; � C� e' �� 4 ', j O L O � Y" �� C� r 1� �n c� ��4 ,�,�� W � Q � � W � � , � WOIiK SATiSFACTORY`.PROCEED �PROJEC'f COMPLEfE W ❑OORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPM�NCY 0 ❑CORRECT NfORK,CALL FOR REINSPECTION TEIAPOFiARY V BEFORECONERINQ PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN INSPECTOR WILL RETURN ❑GTATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Caq for the next inspection 4 hou in advance. (952) 249-4600 OwnerlContrector on site• '�`� � `C Inspector: � ti wn�a covrn��.ctors Fn. C�nary CopylSlb Notip