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Home My WebLink About2011-00552 - SAC connection '�'" CITY OF ORONO PERMIT NO.: 2011-00552 t 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/29/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2330 GLENDALE COVE LA PIN : 34-118-23-33-0063 LEGAL DESC : GLENDALE COVE : LOT 004 BLOCK 001 PERMIT TYPE : SEWER& WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECT[ON NOTE: SAC PAID ON BUILDING PERMIT 201 1-00428 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 GROTH SEWER& WATER WATER CONNECT/DISCONNECT/REPAIR 50.00 775 TOWER DRIVE HAMEL,MN 55340- STATE SURCHARGE SEWER&WATER 5.00 (763)478-6712 TOTAL 105.00 Minnesota State License#: 058606-PM OWNER RHOADS,NICK&JENNY 140 CARLSON PKWY#308 MINNETONKA, MN 55345- ACREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to Ihe 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 rclated work which requires separatc 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 aRer 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 at any tigte f due ause. � / / Appli _ Permite Signature Date Issued By S ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB VE. •' aolt-ooy2b v FOR CITY USE ONI.Y �Q � CI[V Of�1'OIIO Date Received: Pennit# r 4 �t P.O.Box 66 \ � .i; 2750 Kelley Park��ay ❑ fn-I louse SAC Detennination Forni Completed � �i:� �' �*;� Crystal Bay,MN$j323 �� ,r •$o`;� (952)249-4600 Approved By(If Required): �aaxo�' CITY OF ORONO–SEWER & WATER/ GENERAL PERMIT (*Note:Some pennits may require approval by thc[3uilding Official and/or Public Works Department*) (AI,L PERJII'I'S- M:n�be subiect to further review and m:��not be issued�r�hen the aonlication is receivetl) GENERAL INFORMATION 1. 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 permit card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Uepartment(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MA1N 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��ith State Code 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 I ) �Residential (May Require Approval) ❑ Commercial (Approval Required) ❑ Ne�� Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hool<-Up to Water Job Site/Owner Information: Site Address: 'J� ' � � `�, � � C� �� ti�� Owner: �Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Inforn�ation: _. � \.___ - ; Contractor:��J � Contact Person: C �,�-- r. Q / Address: � �7 ��G�-��(��,(��tate License #: v S U ��(U —�/�"/ �-- - v / City: �� Zip�� xpiration Date: � � / � �� Phone:�� Alternate Phone: � G� � �� •+► DETERMINING PERMIT FEES ❑ SAC Charge(2011 Rate=$2,230.00) $ (SAC Charge must accompany all se�ver permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) [� Sewer Connec 'on/ Disconnect/Repair($50.00/Per Stub) $ Pipe size�inches;material Schd 40 air tested; cast iron Water Connection/Disconnect/Repair($50.00/Per Stub) $ � Pipe size inches;material Schd 40 air tested; copper � ❑ Water Availabilit�� For Future Hook-Up to VVater($50.00) $ Water Availabilitv Explanation: 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 Peimit 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 5.00 3. POSTAGE& HANDLWG(Only on Mail-In Applications) $ 2.00 4. TOTAL PER1�11T FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATION —WATER METERS ■ WATER��1ETERS must be picked up and paid for at Orono City Hall,these are on a separate permit. ■ WA7'ER MGTERS 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 Pernlit, 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 state e s made on this application are, true and correct. � i / s � Applicant: Date: �P� % v D E TIME � CITY OF ORONO CALLED IN � INSPECTION NOTIC SCHEDULED 7-�-�/ % PERMIT NO.oZ(�`�OQSS��coMPLETED �, � ADDRESS o2 33 � G��'c-L��2 C�O�ZJ'2- �� OWNER TELEPHONE NO. � 1z -� � ��7C� CONTRACTOR �r�T �� o� �� >: DESCRIPTION � )��(J1�C-`7� I�CJ�Z� � ly� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q ti � �I� ��r �_IL � W � � GW ❑WORKSATISFACTOR : 'D � i i PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED � r ISSUE CERTIFICATE OF OCCUPANCY W O ❑CARRECT WORK,CALI FOR REINSPE�lQ_�� TEMPORARY V BEFORE COVERING NENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�0 Owner/Contract r n it : Inspector. - White Copylinspector's File Canary CopylSite Notice