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Home My WebLink About2011-01460 - sewer connection CITY OF ORONO PERMIT NO.: 2011-01460 2750 KELLEY PARKWAY • ORONO, MN 55356- �ATE IssuEn: 1U2U2011 + 952 249-4600 FAX: 952 249-4616 ADDRESS : 2320 GLENDALE COVE LA PIN : 34-118-23-33-0064 LEGAL DESC : GLENDALE COVE : LOT 005 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 BOLLIG& SONS, INC. WATER CONNECT/DISCONNECT/REPAIR 50.00 11401 COUNTY ROAD 3 HOPKINS, MN STATE SURCHARGE SEWER& WATER 5.00 (612)938-4433 TOTAL 105.00 OWNER Bohland Development 825 WAYZATA BLVD E WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approvcd plans and specifications,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 separatc permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or no[specitied hereia 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 Yor assuring all rcquired inspections are requested in conformance with the State Building Code.This permit may be revQl�efi at anyfiime for due cause. L � _ � , f ' r.r,��---___ ! C . I � � � � ppl�Ea n itee Signature Date � Issued By Sig a ure SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB s � FOR CI'CY USE ONLY �� Clty Of vY0110 Date Received: Permit# P.O.Box 66 � 27�0 Kelley Parkway ❑[n-House SAC Detenninahon Form Completed .� • � Gystal B�iy,MN 55323 �F '�' ' o` (952)249-4600 Approved By(If Required): ��xesxo�`w CITY OF ORONO— SEWER & WATER/ GENERAL PERMIT (*Vote:Some permit,may require approval by the Buildiug Official�nd/or Public Works Department*) (ALI PI+�Ki�11TS- M�rv be sublect tu further re�iew and mav not bc issued when the�pplication is recei��ed) GENERAL INFORMATION 1. You may apply for utility permits by mail or in person at thc City ofticcs. 2. Mailed in applications are subject to the postagc and handling fee shown below. Pcrulit cards will bc scnt by rcturn mail within 2 busincss days. 3. Permits are not valid until you receive a permit card. 4. Work must not begin�mlcss thc permit card is available on thc job site. 5. Utility connection pernlits may be issued to licensed contractors only. 6. Contact the Public Works Dcpartmcnt(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN�vithout express approval of the Public Works Department. Iss�iance of a permit does not grant this approval. 7. All work must be done in accordance witl� State Codc 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 A 1 ) �Residential (May Requirc Approval) ❑ Commercial(Approval Required) �] New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect ❑ Water Availability Conncction For Futurc Hook-Up to Watcr Job Site/ Owner Information: S ite Address: �.3 0�.0 ��-e,��Ct,�� Co v�2 �•-t Owner: (�v1�+.�av�� -eS Mailing Address: �ZS W0."I�� City: ��u.0 7ov�-'0. Zip: S53`� � Home Phone: ��,z.,—' y�� '�� Alternate Phone: ��2'ZZ � — �� Contractor Information: Contractor: o� .�� 0. Sov�.S Contact Person: �� /U��So� p�p�e.L�.y c.,r �k 3�� Address: C�y,0 � Cc� �e,�, 3 State License #: City: �'1/�.lU Zip:S�3�E3 Expiration Date: !Z'� $�� Phone: �SZ- R 3�-L!/3 3 Alternate Phone: ��Z-�6�-��' � . � � DETERMINING PERMIT FEES ❑ SAC Charge(2011 Rate=$2,230.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can detcrmine if applicable) (If not prepaid, a se�ver connection permit will not be issued) [�Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size��" _inches; material�Schd 40 air tested; cast iron �'Watcr Connection/Disconnect/Repair($50.00/Per Stub) � Pipe sire__(_inclies; material X Sc�40 air tested; coppei- P� � ❑ Watcr Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Explanation: Contractor instalted line to inside of house for future hook-up. This linc will be inspected by the Public Works Department. Rcquired Before Water Connection Permit is Issucd: 1. Issue Water Meter&Horn Periuit 2. Any Additional Connection Fecs Paid(If Applicable) Issue Watcr Conncction Pcrmit: 1. Collcct Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 5.00 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�nust be picked up and paid for at Orono City HaLI, these are on a separate permit. ■ WATER METEKS must be set and sealed by Orono Water Department (952) 249-4600, upon complction of'metcr installation. The undersigned hereby applies to the City of Orono far 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 statcinents made on this application are, true and correct. Applicant: Date: y� "'�g�� I Reset Form /�/�T� TIME , / CITY OF ORONO CALLED IN � �'' �J INSPECTION NOT E n SCHEDULED � � PERMITNO. �� 1 d � �`' COMPLETED ADDRESS�7�('�,(l� �� OWNER TELEPHONE NO. ��Z- l d Z � `� CONTRACTOR � /`j"I,�� : DESCRIPTION �5��'�� G��' "��' ' � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � ` � `� w- • � 0 � W � Q � Z W � ; pv� � GW�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE _� W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �Q52� 249-46�� OwnerlContractor on site: Inspector. White Copylinspector's File Canary CopylSite Notice